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A Single-Institution Review of Portosystemic Shunts in Children : An Ongoing Discussion
Joint Authors
Moir, C. R.
McKenzie, T. J.
Lillegard, J. B.
Nagorney, D. M.
Ishitani, M. B.
Hanna, A. M.
Source
Issue
Vol. 2010, Issue 2010 (31 Dec. 2010), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2010-05-06
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Purpose.
Review the safety and long-term success with portosystemic shunts in children at a single institution.
Methods.
An IRB-approved, retrospective chart review of all children ages 19 and undergoing surgical portosystemic shunt from January 1990–September 2008.
Results.
Ten patients were identified, 8 females and 2 males, with a mean age of 15 years (range 5–19 years).
Primary diagnoses were congenital hepatic fibrosis (5), hepatic vein thrombosis (2), portal vein thrombosis (2), and cystic fibrosis (1).
Primary indications were repeated variceal bleeding (6), symptomatic hypersplenism (2), and significant liver dysfunction (2).
Procedures performed were distal splenorenal bypass (4), side-to-side portocaval shunt (3), proximal splenorenal shunt (2), and an interposition H-graft portocaval shunt (1).
There was no perioperative mortality and only minor morbidity.
Seventy percent of patients had improvement of their symptoms.
Eighty percent of shunts remained patent.
Two were occluded at a median follow-up of 50 months (range 0.5–13.16 years).
Two patients underwent subsequent liver transplantation.
Two patients died at 0.5 and 12.8 years postoperatively, one from multisystem failure with cystic fibrosis and one from post-operative transplant complications.
Conclusions.
The need for portosystemic shunts in children is rare.
However, in the era of liver transplantation, portosystemic shunts in selected patients with well-preserved liver function remains important.
We conclude that portosystemic shunts are safe and efficacious in the control of variceal hemorrhage and symptoms related to hypersplenism.
American Psychological Association (APA)
Lillegard, J. B.& Hanna, A. M.& McKenzie, T. J.& Moir, C. R.& Ishitani, M. B.& Nagorney, D. M.. 2010. A Single-Institution Review of Portosystemic Shunts in Children : An Ongoing Discussion. HPB Surgery،Vol. 2010, no. 2010, pp.1-6.
https://search.emarefa.net/detail/BIM-511961
Modern Language Association (MLA)
Lillegard, J. B.…[et al.]. A Single-Institution Review of Portosystemic Shunts in Children : An Ongoing Discussion. HPB Surgery No. 2010 (2010), pp.1-6.
https://search.emarefa.net/detail/BIM-511961
American Medical Association (AMA)
Lillegard, J. B.& Hanna, A. M.& McKenzie, T. J.& Moir, C. R.& Ishitani, M. B.& Nagorney, D. M.. A Single-Institution Review of Portosystemic Shunts in Children : An Ongoing Discussion. HPB Surgery. 2010. Vol. 2010, no. 2010, pp.1-6.
https://search.emarefa.net/detail/BIM-511961
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-511961