[IMMEDIATE RESULTS OF MESOCAVAL SHUNTING IN SURGICAL TREATMENT OF PORTAL HYPERTENSION IN CHILDREN]

Area of Science:

• Pediatric Surgery
• Hepatology
• Vascular Surgery

Background:

• Portal hypertension (PH) in children often leads to severe gastroesophageal varices and hemorrhage.
• Surgical interventions are crucial for managing PH complications in pediatric patients.
• Previous surgical methods, like disconnecting operations, have shown limited efficacy.

Purpose of the Study:

• To analyze the efficacy of mesocaval shunting (MCSH) in treating portal hypertension (PH) in a pediatric cohort.
• To evaluate MCSH as a treatment option, particularly for recurrent hemorrhage.
• To compare the outcomes of MCSH with traditional disconnecting operations.

Main Methods:

• Retrospective analysis of 69 children treated for portal hypertension.
• Mesocaval shunting (MCSH) was performed, with hemorrhage from gastroesophageal varices as the primary indication.
• MCSH was utilized as a reoperation in 53.6% of cases.

Main Results:

• Mesocaval shunting (MCSH) achieved an average decompression of the portal vein system in 30.9% of patients.
• The overall efficacy of surgical treatment for PH using MCSH reached 85.5%.
• This represents a significant improvement compared to the 36% efficacy observed after disconnecting operations.

Conclusions:

• Mesocaval shunting (MCSH) is a highly effective surgical treatment for pediatric portal hypertension (PH).
• MCSH significantly improves outcomes and reduces hemorrhage in children with PH, especially when compared to disconnecting procedures.
• The reoperation rate indicates MCSH's utility in complex or previously treated cases.