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Related Experiment Videos

Rapid temporary portosystemic bypass.

Ernesto P Molmenti1, J Wallis Marsh, John J Fung

  • 1The Johns Hopkins Hospital, Baltimore, Maryland, USA.

Digestive Diseases and Sciences
|February 22, 2002
PubMed
Summary
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Piggyback orthotopic liver transplantation has largely replaced extracorporeal venovenous bypass. A simple cannula technique can create a temporary internal portocaval shunt to manage hemodynamic instability during liver transplants.

Area of Science:

  • Hepatobiliary Surgery
  • Vascular Surgery
  • Transplantation Medicine

Background:

  • Extracorporeal venovenous bypass is infrequently used in liver transplantation.
  • Orthotopic liver transplantation with the piggyback technique is the standard approach.
  • Hemodynamic instability can occur during liver transplantation, necessitating interventions.

Purpose of the Study:

  • To describe a novel, simple technique for temporary internal portocaval shunt creation.
  • To provide an alternative method for managing hemodynamic instability during liver transplantation.

Main Methods:

  • A short plastic cannula is used to create a shunt.
  • The shunt connects the portal vein to the inferior vena cava (IVC).
  • This technique serves as a temporary measure to stabilize hemodynamics.

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Main Results:

  • The described technique is quick and simple to implement.
  • It effectively bridges the portal vein and IVC.
  • It offers a solution for hemodynamic instability in liver transplant patients.

Conclusions:

  • This cannula-based portocaval shunt is a valuable adjunct in liver transplantation.
  • It provides a rapid and straightforward method to address hemodynamic challenges.
  • It potentially simplifies surgical management during complex liver transplant procedures.