Surgical portosystemic shunts and the Rex bypass in children: a single-centre experience.
HPB (Oxford)
; 11(3): 252-7, 2009 May.
Article
em En
| MEDLINE
| ID: mdl-19590656
ABSTRACT
OBJECTIVES:
This study aimed to illustrate the indications for, and types and outcomes of surgical portosystemic shunt (PSS) and/or Rex bypass in a single centre.METHODS:
Data were collected from children with a PSS and/or Rex bypass between 1992 and 2006 at Mount Sinai Medical Center, New York.RESULTS:
Median age at surgery was 10.7 years (range 0.3-22.0 years). Indications included (i) refractory gastrointestinal bleeding in portal hypertension associated with (a) compensated cirrhosis (n= 12), (b) portal vein thrombosis (n= 10), (c) hepatoportal sclerosis (n= 3); (ii) refractory ascites secondary to Budd-Chiari syndrome (n= 3), and (iii) familial hypercholesterolaemia (n= 4). There were 20 distal splenorenal, four portacaval, three Rex bypass, two mesocaval, two mesoatrial and one proximal splenorenal shunts. At the last follow-up (median 2.9 years, range 0.1-14.1 years), one shunt (Rex bypass) was thrombosed. Two patients had died and two had required a liver transplant. These had a patent shunt at last imaging prior to death or transplant.CONCLUSIONS:
Portosystemic shunts and Rex bypass have been used to manage portal hypertension with excellent outcomes. In selected children with compensated liver disease, PSS may act as a bridge to liver transplantation or represent an attractive alternative.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Idioma:
En
Revista:
HPB (Oxford)
Assunto da revista:
TERAPEUTICA
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Estados Unidos