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Published on: June 27, 2025
Surgical guidelines for the management of extra-hepatic portal vein obstruction
Riccardo Superina1, Benjamin Shneider, Sukru Emre
1Northwestern University Feinberg School of Medicine, Evanston, IL, USA.
Abstract:
The recent introduction of the meso Rex bypass raises a possible paradigm shift in the therapeutic approach to extra-hepatic portal vein obstruction (EHPVO). Long-term follow-up of patients with EHPVO has revealed a variety of complications including variceal hemorrhage, hypersplenism, biliopathy, growth/development retardation and neuropsychiatric disease. The meso Rex bypass restores physiologic blood flow to the liver. Thus, when feasible, the meso Rex bypass should be considered in patients with clinically significant manifestations of EHPVO. The opinions of a panel of experts regarding the surgical approach to the management of EHPVO are presented.
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