Reappraisal of shunt surgery for extrahepatic portal vein obstruction in adults: Report of a single-center case series.

Details

Serval ID
serval:BIB_5ADA001E9DD4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Reappraisal of shunt surgery for extrahepatic portal vein obstruction in adults: Report of a single-center case series.
Journal
Hepatology Research
Author(s)
Kokudo T., Bonard E., Gillet M., Kokudo N., Halkic N.
ISSN
1386-6346 (Print)
ISSN-L
1386-6346
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
45
Number
13
Pages
1307-1311
Language
english
Abstract
AIM: Extrahepatic portal venous obstruction (EHPVO) is a relatively rare disease in adults. The clinical significance of shunt surgery for EHPVO in adult cases remains unclear.
METHODS: We retrospectively analyzed the patient characteristics and the results of shunt surgery in 13 adult cases of EHPVO treated between March 1995 and March 2013 at a tertiary care hospital in Switzerland. The indication for shunt surgery was recurrent bleeding after endoscopic treatment. To update the outcomes of shunt surgery in adult cases of EHPVO, we performed a systematic review of published work to examine this issue.
RESULTS: The mean age of the 13 patients in the present case series was 41.8 years (range, 20-68), and the mean follow-up duration after surgery was 4.4 years (range, 1-16). The types of shunt surgery performed were mesocaval shunt (n = 8), portacaval shunt (n = 2), splenorenal shunt (n = 1) and mesorenal shunt (n = 2). Two patients (15%) developed postoperative rebleeding, which was successfully treated by endoscopic treatment. None of the patients developed postoperative hepatic encephalopathy. No operative-related deaths occurred in this series. Six studies, including our own, were identified in the published work. The overall mortality rate was 0-3.7%, and no cases of encephalopathy were observed. The rebleeding rate ranged 2.5-23%.
CONCLUSION: Shunt surgery for EHPVO in adults after the failure of endoscopic treatment is feasible, with acceptable outcomes at specialized centers. This surgical procedure should always be taken into consideration when managing adult cases of EHPVO.
Pubmed
Web of science
Create date
19/02/2016 19:45
Last modification date
20/08/2019 15:13
Usage data