title: Portosystemic Shunt Surgery in Patients with Idiopathic Noncirrhotic Portal Hypertension.
abstract: BACKGROUND Idiopathic noncirrhotic portal hypertension (INCPH) is a rare disease characterized by increased portal venous pressure in the absence of cirrhosis and other causes of liver diseases. The aim of the present study was to present our results in using portosystemic shunt surgery in patients with INCPH. MATERIAL AND METHODS Patients who had been referred to our Liver Transplantation Institute for liver transplantation and who had undergone surgery from January 2010 to December 2015 were retrospectively analyzed. Patients with INCPH who had undergone portosystemic shunt procedure were included in the study. Age, sex, symptoms and findings, type of portosystemic shunt, and postoperative complications were assessed. RESULTS A total of 1307 patients underwent liver transplantation from January 2010 to December 2015. Eleven patients with INCPH who did not require liver transplantation were successfully operated on with a portosystemic shunt procedure. The mean follow-up was 30.1±19 months (range 7-69 months). There was no mortality in the perioperative period or during the follow-up. Two patients underwent surgery again due to intra-abdominal hemorrhage; one had bleeding from the surgical site except the portacaval anastomosis and the other had bleeding from the h-graft anastomosis. No patient developed encephalopathy and no patient presented with esophageal variceal bleeding after portosystemic shunt surgery. Shunt thrombosis occurred in 1 patient (9.9%). Only 1 patient developed ascites, which was controlled medically. CONCLUSIONS Portosystemic shunt surgery is a safe and effective procedure for the treatment of patients with INCPH.
authors.affiliation: Liver Transplantation Institute, Inonu University, Malatya, Turkey.
authors.forename: Servet
authors.initials: S
authors.lastname: Karagul
authors.affiliation: Liver Transplantation Institute, Inonu University, Malatya, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Yagci
authors.affiliation: Liver Transplantation Institute, Inonu University, Malatya, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Tardu
authors.affiliation: Liver Transplantation Institute, Inonu University, Malatya, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Ertugrul
authors.affiliation: Liver Transplantation Institute, Inonu University, Malatya, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Kirmizi
authors.affiliation: Liver Transplantation Institute, Inonu University, Malatya, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Sumer
authors.affiliation: Liver Transplantation Institute, Inonu University, Malatya, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Isik
authors.affiliation: Liver Transplantation Institute, Inonu University, Malatya, Turkey.
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Kayaalp
authors.affiliation: Liver Transplantation Institute, Inonu University, Malatya, Turkey.
authors.forename: Sezai
authors.initials: S
authors.lastname: Yilmaz
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D016896:Treatment Outcome; D055815:Young Adult