Wen Zhe,Zhang Binbin.Preoperative assessments and operations for prehepatic portal hypertension in children[J].Journal of Clinical Pediatric Surgery,,18():994-998.[doi:10.3969/j.issn.1671-6353.2019.12.002]
Preoperative assessments and operations for prehepatic portal hypertension in children
- Keywords:
- Liver Diseases; Hypertension; Portal; Surgical Procedures; Operative; Health Status Indicators; Child
- CLC:
- R726.1;R575;R657.3+4
- Abstract:
- Prehepatic portal hypertension (PHT) is the most common type of portal hypertension in children.Its treatment strategies have changed fundamentally over the last two decades.Meso-rex bypass is a first choice.In the Baveno Ⅵ consensus,Meso-rex bypass was recommended as the primary and secondary prophylaxis of variceal bleeding in PHT children.In those with prehepatic PHT,coagulation status,blood vessels and liver parenchyma should be evaluated preoperatively.The overall prognosis of Meso-rex bypass is satisfactory.
References:
1 Chiu B,Superina RA.Encephalopathy caused by a splenorenal shunt can be reversed by performing a mesenteric-to-left portal vein bypass[J].J Pediatr Surg,2006,41(6):1177-1179.DOI:10.1016/j.jpedsurg.2006.01.075.
2 Khanna R,Sarin SK.Idiopathic portal hypertension and extrahepatic portal venous obstruction[J].Hepatol Int,2018,12(1):148-167.DOI:10.1007/s12072-018-9844-3.
3 Mascarenhas MI,Carneirod MM,Sande LP.Cavernous transformation of portal vein[J].Acta Médica Portuguesa,2012,25(5):340.DOI:10.3810/pgm.2012.09.2601.
4 Vara-Thorbeck R,Maza-Inza J.Simultaneous treatment of portal hypertension and hepatic cirrhosis by splenohepatoplasty[J].Surg Gynecol Obstet,1978,147(3):391-396.
5 Chiu B,Superina R.Extrahepatic portal vein thrombosis is associated with an increased incidence of cholelithiasis[J].J Pediatr Surg,2004,39(7):1059-1061.DOI:10.1016/j.jpedsurg.2004.03.051.
6 de Ville De Goyet J,Alberti D,Clapuyt P,et al.Direct bypassing of extrahepatic portal venous obstruction in children:A new technique for combined hepatic portal revascularization and treatment of extrahepatic portal hypertension[J].J Pediatr Surg,1998,33(4):597-601.DOI:10.1016/s0022-3468(98)90324-4.
7 Superina R,Bambini DA,Lokar J,et al.Correction of Extrahepatic Portal Vein Thrombosis by the Mesenteric to Left Portal Vein Bypass[J].Ann Surg,243(4):515-521.DOI:10.1097/01.sla.0000205827.73706.97.
8 Lautz TB,Sundaram SS,Whitington PF,et al.Growth impairment in children with extrahepatic portal vein obstruction is improved by mesenterico-left portal vein bypass[J].J Pediatr Surg,2009,44(11):2070.DOI:10.1097/01.sla.0000205827.73706.97.
9 Mack CL,Zelko FA,Lokar J,et al.Surgically Restoring Portal Blood Flow to the Liver in Children With Primary Extrahepatic Portal Vein Thrombosis Improves Fluid Neurocognitive Ability[J].Pediatrics,2006,117(3):e405-e412.DOI:10.1542/peds.2005-1177.
10 Sharif K,Mckiernan P,de Ville De Goyet J.Mesoportal bypass for extrahepatic portal vein obstruction in children:close to a cure for most![J].J Pediatr Surg,2010,45(1):276.DOI:10.1016/j.jpedsurg.2009.08.019.
11 di Francesco F,Grimaldi C,de Ville de Goyet J.Meso-Rex Bypass-A Procedure to Cure Prehepatic Portal Hypertension:The Insight and the Inside[J].J Am Coll Surg,2014,218(2):e23-e36.DOI:10.1016/j.jamcollsurg.2013.10.024.
12 Superina R,Shneider B,Emre S,et al.Surgical guidelines for the management of extra-hepatic portal vein obstruction[J].Pediatr Transplant,2006,10(8):908-913.DOI:10.1111/j.1399-3046.2006.00598.x.
13 Bertocchini A,Falappa P,Grimaldi C,et al.Intrahepatic portal venous systems in children with noncirrhotic prehepatic portal hypertension:Anatomy and clinical relevance[J].J Pediatr Surg,2014,49(8):1268-1275.DOI:10.1016/j.jpedsurg.2013.10.029.
14 Shneider BL,de Ville de Goyet J,Leung DH,et al.Primary prophylaxis of variceal bleeding in children and the role of MesoRex Bypass:Summary of the Baveno VI Pediatric Satellite Symposium[J].Hepatology,2016,63(4):1368-1380.DOI:10.1002/hep.28153.
15 Gehrke I,John P,Blundell J,et al.Meso-portal bypass in children with portal vein thrombosis:rapid increase of the intrahepatic portal venous flow after direct portal hepatic reperfusion[J].J Pediatr Surg,2003,38(8):1137-1140.DOI:10.1016/s0022-3468(03)00257-4.
16 Luoto T,Pakarinen M,Mattila I,et al.Mesoportal bypass using a constructed saphenous vein graft for extrahepatic portal vein obstruction-technique,feasibility,and outcomes[J].J Pediatr Surg,2012,47(4):688-693.DOI:10.1016/j.jpedsurg.2011.10.065.
17 Bhat R,Lautz TB,Superina RA.Perioperative strategies and thrombophilia in children with extrahepatic portal vein obstruction undergoing the meso-Rex bypass[J].J Gastrointest Surg,2013,17(5):949-955.DOI:10.1007/s11605-013-2155-z.
18 Gibelli NE,Tannuri AC,Pinho-Apezzato ML,et al.Extrahepatic portal vein thrombosis after umbilical catheterization:is it a good choice for Rex shunt?[J].J Pediatr Surg,2011,46(1):214-216.DOI:10.1016/j.jpedsurg.2010.09.091.
19 Zhang J,Li L,Cheng W.The optimal procedure of modified Rex shunt for the treatment of extrahepatic portal hypertension in children[J].J Vasc Surg Venous Lymphat Disord,2017,5(6):805-809.DOI:10.1016/j.jvsv.2017.02.011.
20 Lautz TB,Kim ST,Donaldson JS,et al.Outcomes of Percutaneous Interventions for Managing Stenosis after Meso-Rex Bypass for Extrahepatic Portal Vein Obstruction[J].J Vasc Interv Radiol,2012,23(3):377-383.DOI:10.1016/j.jvir.2011.11.030.
Memo
收稿日期:2019-10-10。
基金项目:广东省省级科技计划项目(编号:2014A020212026)
作者简介:温哲,Email:wenzhe2005@163.com