Laparoscopic correction of congenital portosystemic shunt in children.
Congenital portosystemic shunt is a rare clinical entity that may progress to jaundice, severe encephalopathy, and pulmonary hypertension and require surgical correction or coil embolization. We present a novel approach to the management of children with congenital portosystemic shunt by means of a minimally invasive surgical technique. Congenital portosystemic shunts were identified between the superior mesenteric vein and inferior vena cava in case 1 and between the splenic vein and left renal vein in case 2. Both of them were successfully ligated by laparoscopic approach, and catheters were subsequently replaced to monitor portal venous pressure. The patients tolerated the procedure well, and short-term results were excellent. Laparoscopic ligation of congenital portosystemic shunt is technically feasible and less invasive to the management of patients with congenital portosystemic shunts, preventing late onset, life-threatening complications.
Kimura
Takuya
T
Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. kimutaku@pedsurg.med.osaka-u.ac.jp
Soh
Hideki
H
Hasegawa
Toshimichi
T
Sasaki
Takashi
T
Kuroda
Seika
S
Yuri
Etani
E
Tomoda
Kaname
K
Fukuzawa
Masahiro
M
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008026:Ligation; D008297:Male; D008642:Mesenteric Veins / Q000002:abnormalities / Q000601:surgery; D011168:Portal System / Q000002:abnormalities / Q000601:surgery*; D012082:Renal Veins / Q000002:abnormalities / Q000601:surgery*; D013162:Splenic Vein / Q000002:abnormalities / Q000601:surgery; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000151:congenital / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*; D014682:Vena Cava, Inferior / Q000002:abnormalities / Q000601:surgery*