Treatment of extrahepatic portal hypertension in children by mesenteric-to-left portal vein bypass: a new physiological procedure.
OBJECTIVE
To achieve hepatic portal revascularisation and decompression of extrahepatic portal hypertension in children with cavernoma and obstruction caused by idiopathic portal vein thrombosis.


METHODS
Selected cases.


METHODS
Teaching hospitals. Belgium and Italy.


METHODS
11 children who weighed between 5.9 and 54 kg (2 emergencies) with symptomatic extrahepatic portal hypertension.


METHODS
Interposition of venous autograft between the superior mesenteric vein and the distal (umbilical) portion of the left portal vein.


METHODS
Improvements in symptoms and endoscopic appearance after operation.


RESULTS
2 bypasses had to be redone because they stenosed; all 11 were patent at the time of writing (median follow-up 6 months, range 1-32 months).


CONCLUSIONS
The bypass effectively relieved symptoms of extrahepatic portal hypertension by restoring normal hepatic portal blood flow.
de Ville de Goyet
J
J
Liver Unit, Birmingham Children's Hospital, UK.
Alberti
D
D
Falchetti
D
D
Rigamonti
W
W
Matricardi
L
L
Clapuyt
P
P
Sokal
E M
EM
Otte
J B
JB
Caccia
G
G
D000293:Adolescent; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004932:Esophageal and Gastric Varices / Q000601:surgery; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D007223:Infant; D007601:Jugular Veins / Q000637:transplantation; D008642:Mesenteric Veins / Q000601:surgery*; D011169:Portal Vein / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome