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A Different Approach Permitting Portal‐Systemic Shunt for Extrahepatic Portal Thrombosis 1
Author(s) -
MARTIN LESTER W.
Publication year - 1972
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1972.tb06758.x
Subject(s) - medicine , portal hypertension , splenic vein , shunt (medical) , portal vein thrombosis , thrombosis , anastomosis , surgery , superior mesenteric vein , fistula , splenectomy , inferior mesenteric vein , portal vein , right gastric vein , radiology , portal venous pressure , spleen , cirrhosis
Studies of the anatomy and pathology in children with extrahepatic portal thrombosis and portal hypertension have shown that the portal vein is generally free of thrombosis for a distance of 1'5 to 2 cm beyond the junction of the superior mesenteric with the splenic vein. In nine children, it has been possible to dissect out this stump of portal vein and anastomore it directly in an end‐to‐side fashion to either the vena cavn or to the central portion of the left renal vein where it crosses anterior to the aorta. The spleen is not removed. The operation can be employed successfully following previous splenectomy, or following a previous unsuccessful conventional splenorenal shunt. Follow‐up evalution has been gratifying, with apparent relief of portal hypertension in each instance. Summary In extrahepatic block, the portal vein is generally free of disease for a distance sufficient to permit its division and an end‐to‐side anastomosis to the vena cava or the left renal vein near the cava. In our experience with nine consecutive patients, this has proved to be a successful and effective means of portal decompression. No adverse effects have been encountered relative to Eck fistula in the growing child.