Related Experiment Videos
Portal derivation surgery in children. A long-term follow-up report
Insights
Portal diversion surgery effectively treated gastro-intestinal bleeding in children and adults with portal hypertension. Shunt operations prevented recurrent esophageal bleeding without mortality or shunt-related complications in this study.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Vascular Surgery
Background:
- Portal hypertension in children and adults can lead to severe gastro-intestinal bleeding from esophageal varices.
- Splenectomy is a common prior intervention for some patients with hypersplenism or complications.
- Recurrent bleeding necessitates surgical intervention to manage the condition.
Purpose of the Study:
- To evaluate the efficacy and safety of portal diversion surgery in managing recurrent gastro-intestinal bleeding due to portal hypertension.
- To assess long-term outcomes and complications following various shunt procedures in pediatric and adult patients.
Main Methods:
- A cohort of eight children and two adults with portal hypertension underwent portal diversion surgery.
- Surgical techniques included splenorenal, mesocaval, and portocaval shunts.
- Patients were followed for 2 to 13 years post-surgery.
Main Results:
- No mortality was observed in the study cohort.
- All patients remained free of esophageal bleeding after shunt surgery.
- No complications directly attributable to the shunt procedures were identified.
Conclusions:
- Portal diversion surgery is a safe and effective treatment for recurrent gastro-intestinal bleeding in patients with portal hypertension.
- Shunt operations provide long-term protection against esophageal variceal bleeding.
- This surgical approach offers a viable solution with minimal complications.
Abstract:
Eight children and two adults with portal hypertension were treated by portal diversion surgery. In all cases recurrent gastro-intestinal bleeding from esophageal varices was the indication for shunt-operation. Still in early childhood, three of these patients had had a splenectomy in other hospitals: one emergency splenectomy for hemoperitoneum and two elective splenectomies for hypersplenism. Three operative techniques were used: 5 spleno-renal shunts, 3 meso-caval shunts and 2 porto-caval shunts. All, but one, were followed over a period from 2 to 13 years after shunt-surgery. There was no mortality in this series. After shunting all children remained free of esophageal bleeding. We did not find any complication directly related to the shunt procedure.