Premium
Splenic‐intrahepatic left portal shunt in an adult patient with extrahepatic portal vein obstruction without recurrence after pancreaticoduodenectomy
Author(s) -
Yamamoto Satoshi,
Sato Yoshinobu,
Oya Hiroshi,
Nakatsuka Hideki,
Watanabe Takaoki,
Takizawa Kazuyasu,
Hatakeyama Katsuyoshi
Publication year - 2009
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-008-0002-5
Subject(s) - medicine , shunt (medical) , portal venous pressure , superior mesenteric vein , portal hypertension , occlusion , pancreaticoduodenectomy , radiology , right gastric vein , inferior mesenteric vein , splenic vein , portal vein , surgery , resection , cirrhosis
In the last decade, a superior mesenteric‐intrahepatic left portal shunt (Rex shunt) has been reported for successful management of extrahepatic portal vein obstruction in children. However, in adults, a mesocaval shunt has been generally performed for the surgical management of extrahepatic portal vein obstruction because of the complexity of the underlying disease and the difficulty of the superior mesenteric‐intrahepatic left portal shunt. We herein report an adult patient who was successfully treated by splenic‐intrahepatic left portal shunt with an artificial graft (6‐mm polytetrafluoroethylene) for complete obstruction of the extrahepatic portal vein following pancreaticoduodenectomy. The shunt procedure not only relieved portal hypertension but also restored hepatic portal flow. In the near future, the Rex shunt should be considered for a beneficial management of extrahepatic portal vein obstruction, even in adults.