The usefulness of distal splenorenal shunt in children with portal hypertension for the treatment of severe thrombocytopenia and leukopenia

World Journal of Surgery
Suk-Bae MoonWoo-Ki Kim

Abstract

In the current era of transplantation and therapeutic endoscopy, the role of the distal splenorenal shunt (DSRS) for portal hypertension (PH) has diminished. We reviewed the outcome of the use of DSRS in children to determine the usefulness of this operation. In the follow-up course for PH from 1987 to 2006, 15 patients who developed severe thrombocytopenia (platelet count <50 x 10(3)/mm(3)) and/or leukopenia (WBC count <3000/mm(3)) with normal liver function were referred for DSRS. Primary diagnosis was portal vein thrombosis (N=10) and congenital hepatic fibrosis (N=5). Platelet, WBC count, liver function test, and spleen size were checked before and after DSRS. Shunt patency was accessed postoperatively. Operative morbidity, mortality, and long-term outcomes were measured. Platelet count and WBC count increased in individual patients. Mean value of each count increased significantly after DSRS (p=0.002, .004, respectively). Spleen size decreased significantly (N=7, p=0.018). Shunt patency rate was 100%. There was one postoperative complication and no postoperative mortality. Two patients developed portopulmonary hypertension. No patients underwent subsequent transplantation or endoscopic treatment for gastroesophageal varice...Continue Reading

References

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Citations

Oct 12, 2010·Current Gastroenterology Reports·Elizabeth Mileti, Philip Rosenthal
Apr 14, 2010·Orphanet Journal of Rare Diseases·Serena Botto PoalaRaffaella Colombatti
May 24, 2005·AJR. American Journal of Roentgenology·Jonathan M LorenzGregory Denison
Apr 18, 2014·Journal of Indian Association of Pediatric Surgeons·Nitin SharmaManisha Jana
Oct 26, 2012·International Journal of Hepatology·Alejandro Costaguta, Fernando Alvarez
Oct 3, 2009·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Hiroshi YoshidaTakashi Tajiri
Apr 4, 2015·Journal of Pediatric Surgery·Fabrizio di FrancescoJean de Ville de Goyet
Feb 23, 2018·Journal of Pediatric Gastroenterology and Nutrition·Andrew WoernerEric J Monroe
Sep 12, 2020·Acta Anaesthesiologica Scandinavica·Andreas Bender JonssonLene Russell
Jul 12, 2017·Vascular Specialist International·Seung-Kee MinSang Joon Kim
Sep 12, 2015·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Benjamin L ShneiderGeorge V Mazariegos
Jan 4, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Shannon ZielsdorfJuliet Emamaullee

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