title: Variant meso-Rex bypass with transposition of abdominal autogenous vein for the management of idiopathic extrahepatic portal vein obstruction: a retrospective observational study.
abstract: BACKGROUND
  The aim of this study was to evaluate whether variant meso-Rex bypass with transposition of abdominal autogenous vein can be used as an alternative treatment modality for selected patients with symptomatic extrahepatic portal vein obstruction.
  
  
  METHODS
  This was a retrospective review of six consecutive patients who received this alternative procedure for the treatment of symptomatic portal hypertension secondary to idiopathic extrahepatic portal vein obstruction. Their clinical characteristics, operative procedures and outcomes were analyzed retrospectively.
  
  
  RESULTS
  The procedure was attempted in six patients, and all had a patent shunt established by intraoperative portography at the end of the procedure; the coronary vein was used in four patients and the inferior mesenteric vein was used in two. During the median period of 23.5 months (range 10-30 months), follow-up was uneventful except one patient; reduced portal hypertension and no new episodes of gastrointestinal bleeding were observed in all patients, with the exception of one patient with shunt stenosis and recurrent varix bleeding who had to undergo endovascular treatment to restore portal vein blood flow. Technical and clinical success was achieved in all patients.
  
  
  CONCLUSIONS
  This procedure could be used safely and effectively to treat selected patients with portal hypertension secondary to extrahepatic portal vein obstruction.
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736, Korea. haty@amc.seoul.kr.
authors.forename: Tae-Yong
authors.initials: TY
authors.lastname: Ha
authors.affiliation: Departments of Pediatrics, University of Ulsan College of Medicine and Asan Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736, Korea. kmkim@amc.seoul.kr.
authors.forename: Kyung-Mo
authors.initials: KM
authors.lastname: Kim
authors.affiliation: Departments of Radiology, University of Ulsan College of Medicine and Asan Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736, Korea. kogy@amc.seoul.kr.
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Ko
authors.affiliation: Departments of Pediatrics, University of Ulsan College of Medicine and Asan Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736, Korea. arvyn@hanmail.net.
authors.forename: Seak Hee
authors.initials: SH
authors.lastname: Oh
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736, Korea. twkwon2@amc.seoul.kr.
authors.forename: Tae-Won
authors.initials: TW
authors.lastname: Kwon
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736, Korea. ypcho@amc.seoul.kr.
authors.forename: Yong-Pil
authors.initials: YP
authors.lastname: Cho
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736, Korea. sglee2@amc.seoul.kr.
authors.forename: Sung-Gyu
authors.initials: SG
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000150:complications / Q000601:surgery; D019468:Disease Management; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery*; D007223:Infant; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery*; D011169:Portal Vein; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult