Open AccessFrom portal to splanchnic venous thrombosis: What surgeons should bear in mind
Author(s) -
Quirino Lai,
Gabriele Spoletini,
Rafael Soares Pinheiro,
Fabio Melandro,
Nicola Guglielmo,
Jan Lerut
Publication year - 2014
Publication title -
world journal of hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.913
H-Index - 55
ISSN - 1948-5182
DOI - 10.4254/wjh.v6.i8.549
Subject(s) - medicine , contraindication , liver transplantation , anastomosis , portal vein thrombosis , surgery , context (archaeology) , thrombosis , portal hypertension , transplantation , splanchnic , portal venous pressure , venous thrombosis , cirrhosis , radiology , blood flow , pathology , paleontology , alternative medicine , biology
The present study aims to review the evolution of surgical management of portal (PVT) and splanchnic venous thrombosis (SVT) in the context of liver transplantation over the last 5 decades. PVT is more commonly managed by endovenous thrombectomy, while SVT requires more complex technical expedients. Several surgical techniques have been proposed, such as extensive eversion thrombectomy, anastomosis to collateral veins, reno-portal anastomosis, cavo-portal hemi-transposition, portal arterialization and combined liver-intestinal transplantation. In order to achieve satisfactory outcomes, careful planning of the surgical strategy is mandatory. The excellent results that are obtained nowadays confirm that, even extended, splanchnic thrombosis is no longer an absolute contraindication for liver transplantation. Patients with advanced portal thrombosis may preferentially be referred to specialized centres, in which complex vascular approaches and even multivisceral transplantation are performed.