Previous portal hypertension surgery negatively affects results of mesenteric to left portal vein bypass

Journal of Pediatric Surgery
Anthony C ChinRiccardo A Superina

Abstract

The mesenteric to left portal vein bypass (MLPVB) has been successfully used to treat extrahepatic portal vein obstruction (EHPVO) in children. We examined the effect of failed prior surgical or radiological procedures intended to treat complications of portal hypertension on the success rate of subsequent MLPVB surgery. Sixty-two patients younger than 18 years with EHPVO underwent MLPVB between 1997 and 2006. Children were divided into 3 groups: those with no prior surgery related to portal hypertension, those with prior portosystemic shunts, and those with either splenectomy or mesenteric vascular embolization procedures. The effect of prior procedures on the patency rate of the MLPVB was then examined. Of 62 children, 11 (17.7%) had significant procedures to treat symptoms of portal hypertension: 6 had at least 1 portosystemic shunt attempt, 3 had isolated splenectomy, and 2 had embolization of the splenic artery or coronary and peripancreatic varices. Patients with previous portal hypertension surgery were significantly older and larger than those with no surgery. Patients with no prior interventions had a significantly higher MLPVB patency rate (88.2%, 45/51) than those with no prior interventions (63.6%, 7/11). Prior sple...Continue Reading

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Citations

Mar 23, 2011·Current Gastroenterology Reports·Stefan Scholz, Khalid Sharif
May 15, 2010·HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery·J B LillegardD M Nagorney
Nov 28, 2012·Journal of the American College of Surgeons·Timothy B LautzRiccardo A Superina
Mar 1, 2012·Journal of Vascular and Interventional Radiology : JVIR·Timothy B LautzRiccardo A Superina
Sep 15, 2012·Journal of Pediatric Surgery·Rafael M Trinchet Soler, Yanet Hidalgo Marrero
Mar 17, 2018·Pediatric Surgery International·Jin-Shan ZhangWei Cheng
Nov 12, 2014·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Zhang WeiLiu Shu Wei
Jan 4, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Shannon ZielsdorfJuliet Emamaullee

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