A New Procedure for the Treatment of Extrahepatic Portal Hypertension in Children: Portal Cavernoma-Rex Shunt with Interposition of Grafted Portal Vessel

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Presentation transcript:

A New Procedure for the Treatment of Extrahepatic Portal Hypertension in Children: Portal Cavernoma-Rex Shunt with Interposition of Grafted Portal Vessel Jin-Shan Zhang, MMed, Long Li, MD, PhD, Wei Cheng, PhD, MBBS, FRCS Journal of the American College of Surgeons Volume 222, Issue 6, Pages e71-e76 (June 2016) DOI: 10.1016/j.jamcollsurg.2016.03.020 Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 1 Angiography of superior mesenteric vein shows cavernous transformation of portal vein, esophageal and gastric varices, with a short dilation segment of gastric coronary vein. Journal of the American College of Surgeons 2016 222, e71-e76DOI: (10.1016/j.jamcollsurg.2016.03.020) Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 2 Angiography of umbilical vein shows patent left portal vein without stenosis. Journal of the American College of Surgeons 2016 222, e71-e76DOI: (10.1016/j.jamcollsurg.2016.03.020) Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 3 The extrahepatic portal vein was dissected to exposed cavernous transformation of portal vein. Journal of the American College of Surgeons 2016 222, e71-e76DOI: (10.1016/j.jamcollsurg.2016.03.020) Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 4 The inferior mesenteric vein was dissected and used as the bypass vein. Journal of the American College of Surgeons 2016 222, e71-e76DOI: (10.1016/j.jamcollsurg.2016.03.020) Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 5 Portal cavernoma left portal vein with interposition of grafted vessels. (A) Preoperation. (B) Postoperation. Journal of the American College of Surgeons 2016 222, e71-e76DOI: (10.1016/j.jamcollsurg.2016.03.020) Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 6 Grafted vessels interposed between portal cavernoma and left intrahepatic portal vein. Journal of the American College of Surgeons 2016 222, e71-e76DOI: (10.1016/j.jamcollsurg.2016.03.020) Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 7 Abdominal enhanced CT images. (A) Preoperative CT shows cavernous transformation of portal vein. (B) CT at 10 months post surgery shows patency of bypass vein. Journal of the American College of Surgeons 2016 222, e71-e76DOI: (10.1016/j.jamcollsurg.2016.03.020) Copyright © 2016 American College of Surgeons Terms and Conditions