2015•Zhonghua xiaoerwaike zazhiRequires access
Efficacy and prognosis of spleen-preserving proximal splenic-left intrahepatic portal shunt in the treatment of extra-hepatic portal hypertension in children
Jinshan Zhang, Long Li, Wen-ying Hou, Shuli Liu, Mei Diao, Jun Zhang, Qi Li, Tao Wu, Mao Ye
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Abstract
Objective
To explore the efficacy and prognosis of Spleen-preserving proximal splenic-left intrahepatic portal shunt in the treatment of extra-hepatic portal hypertension in children.
Methods
Four children of portal hypertension were recruited. There were 1 boy and 3 girls with a mean operative age of 3.9 (1.7-5.8) years. Spleen-preserving proximal splenic-left intrahepatic portal shunt was performed. Splenic vein was completely separated from pancreatic bed to its junction with inferior mesenteric vein. And proximal splenic vein was ligated at the branch of splenic vessels. Proximal splenic vein was anastomosed to left portal vein. The mean follow-up period was 20.8 (7-33) months.
Results
The mean operative duration was 237.5 (215-260) min. One patient received transfusion. And the mean postoperative length of hospital stay was 5.3 (4-6) days. Intraoperative portal venous angiography demonstrated the patency of shunt in all patients. Postoperatively, complete blood count normalized and biochemical tests were within normal range. Postoperative ultrasound confirmed shunt patency and satisfactory flow in proximal splenic-portal shunt in each patient. The size of spleen markedly decreased. There was no postoperative recurrence of variceal hemorrhage.
Conclusions
Spleen-preserving proximal splenic-portal shunt is an effective treatment of extra-hepatic portal hypertension.
Key words:
Portal hypertension; Splenic vein; Portal vein