1,973 results match your criteria Portal Vein Obstruction


Portal vein stenting in the management of duodenal varices due to malignant obstruction: A case report and literature review.

Int J Surg Case Rep 2022 Jun 25;95:107246. Epub 2022 May 25.

Department of General Surgery, Calvary Mater Hospital, Waratah, NSW 2298, Australia; Discipline of Surgery, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.

Introduction And Importance: Ectopic varices of the small bowel are a rare complication of portal hypertension. There are various aetiologies that can cause portal vein hypertension such as portal vein obstruction. Each of these pathologies has their own management strategies. Read More

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The Interplay Between Biliary Occlusion and Liver Regeneration: Repeated Regeneration Stimuli Restore Biliary Drainage by Promoting Hepatobiliary Remodeling in a Rat Model.

Front Surg 2022 25;9:799669. Epub 2022 Apr 25.

Department of General, Visceral and Vascular Surgery, University Hospital Jena, Jena, Germany.

Background And Aims: Patients with malignant biliary obstruction do not seem to benefit from "two-stage hepatectomy" due to an impairment of liver regeneration. We designed a novel model of "repeated regeneration stimuli" in rats mimicking a "two-stage hepatectomy" with selective or complete biliary occlusion mimicking Klatskin tumors III° or IV°. Using this new model, we wanted to investigate (1) the impact of preexistent cholestasis of different extent on the time course of liver regeneration and (2) the dynamics of hepatobiliary remodeling under regeneration conditions. Read More

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Technical Aspects and Considerations of Meso-Rex Bypass Following Liver Transplantation With Left Lateral Segment Grafts: Case Report and Review of the Literature.

Front Pediatr 2022 25;10:868582. Epub 2022 Apr 25.

Division of Transplant Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, VA, United States.

In pediatric patients with extrahepatic portal vein obstruction and complications of portal hypertension, but with normal liver function, a meso-Rex bypass (MRB) connecting the superior mesenteric vein to the intrahepatic left portal is the favored surgical management. Pediatric patients with a history of a partial liver transplant (LT), especially living donors, are at greater risk for portal vein complications. Hence, an adequate knowledge of this technique and its additional challenges in the post-LT patient setting is crucial. Read More

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Unconventional Shunts in Extrahepatic Portal Venous Obstruction-A Retrospective Review.

J Clin Exp Hepatol 2022 Mar-Apr;12(2):503-509. Epub 2021 May 29.

Department of Surgical Gastroenterology, SGPGIMS, Lucknow, India.

Background: Proximal splenorenal shunt (PSRS) is one of the most commonly performed portosystemic shunt (PSS) in extrahepatic portal venous obstruction (EHPVO) for portal decompression. Sometimes various anatomical and surgical factors related to the splenic vein and/or left renal vein may make the construction of a PSRS difficult or impossible. Unconventional shunts are required to tide over such conditions. Read More

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Features of Ductular Reaction in Rats with Extrahepatic Cholestasis.

Bull Exp Biol Med 2022 Apr 3;172(6):770-774. Epub 2022 May 3.

Faculty of Medicine, Tbilisi, Georgia.

Ductular reaction develops during liver regeneration, fibrosis, and carcinogenesis. However, the types, stages of formation, and topography of ductular profiles in various pathologies remain insufficiently studied. Using the model of common bile duct occlusion, we showed that the number and topography of ductular profiles are closely related to the duration of biliary obstruction. Read More

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Pipeline Esophagogastric Varices Secondary to Extrahepatic Portal Vein Obstruction Treated Endoscopically with the Assistance of Transileocolic Obliteration: A Case Report.

Intern Med 2022 Apr 30. Epub 2022 Apr 30.

Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan.

Endoscopic injection sclerotherapy (EIS) for esophagogastric varices (EGV) was attempted for a 29-year-old man with extrahepatic portal vein obstruction. However, pipeline varices characterized by a large blood flow volume were present, and the sclerosant did not accumulate sufficiently in them. Transileocolic obliteration (TIO) using coils was performed, but some EGVs and palisading veins remained. Read More

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Physiological reno-portal bypass in liver transplantation with non-tumorous portal vein thrombosis.

Updates Surg 2022 Apr 20. Epub 2022 Apr 20.

General Surgery, Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127, Bergamo, Italy.

Reno-portal anastomosis (RPA) in presence of spleno-renal shunts (SRS) is a physiological option to restore blood flow in liver transplantation with portal vein thrombosis (PVT). Diffuse splanchnic venous system thrombosis (complex PVT) is its main indication but RPA proved to be useful in selected cases of less extensive thrombosis (non-complex PVT). Up until now only two monocentric and one multicentric case series has been published on this topic in addition to few anecdotal reports. Read More

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Usefulness of partial splenic embolization for left-sided portal hypertension in a patient with a pancreatic neuroendocrine neoplasm: a case report and review of the literature.

Clin J Gastroenterol 2022 Apr 16. Epub 2022 Apr 16.

Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.

Left-side portal hypertension (LSPH) is caused by isolated obstruction of the splenic vein and is associated with esophagogastric varices that extend from the lower esophagus to the greater curvature of the gastric body. Here, we report on a 74-year-old man with a pancreatic neuroendocrine neoplasm (NEN) in the pancreatic tail with multiple liver metastases. We decided that partial splenic embolization (PSE) was the best course of treatment to prevent rupture of the gastric varices, which were classified as markedly enlarged, nodular, or tumor-shaped and showed erosion of the mucosa. Read More

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Optimal Treatment for Patients With Cavernous Transformation of the Portal Vein.

Front Med (Lausanne) 2022 24;9:853138. Epub 2022 Mar 24.

Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China.

Cavernous transformation of the portal vein (CTPV) is a sequela of extrahepatic and/or intrahepatic portal vein obstruction caused by a combination of local and risk factors. It was ever taken as a relatively rare disease due to its scant literature, which was mainly based on clinical series and case reports. CTPV often manifests as gastroesophageal variceal bleeding, splenomegaly, and portal biliopathy after the long-term insidious presentation. Read More

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A rare case of duodenal variceal bleeding due to extrahepatic portal vein obstruction successfully treated with endoscopic injection sclerotherapy.

Clin J Gastroenterol 2022 Jun 4;15(3):617-622. Epub 2022 Apr 4.

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

Primary extra-hepatic portal vein obstruction (EHPVO) is a disease that develops ectopic varices due to portal hypertension and obstruction of the portal vein. Since bleeding from ectopic varices is life-threatening, the management of ectopic varices is important for patients with primary EHPVO. Here, we report a case of duodenal variceal bleeding in a patient with primary EHPVO. Read More

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Disseminated tuberculosis following invasive procedures for peripancreatic lymph node tuberculosis with portal vein obstruction: a case report.

Clin J Gastroenterol 2022 Jun 25;15(3):673-679. Epub 2022 Mar 25.

Department of Gastroenterology, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan.

Peripancreatic tuberculous lymphadenopathy can mimic pancreatic cancer on imaging. There have only a few reports on varices from portal vein obstruction due to abdominal tuberculous lymphadenopathy. Iatrogenic disseminated tuberculosis is also rare. Read More

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Usefulness of argon plasma coagulation for bleeding around hepaticojejunal anastomosis.

DEN open 2022 Apr 2;2(1):e69. Epub 2021 Nov 2.

Department of Gastroenterology Faculty of Medicine University of Tsukuba Ibaraki Japan.

Ectopic varices due to extrahepatic portal vein obstruction (EHO) after hepaticojejunostomy have been previously reported. However, few case reports have described angiodysplasia-like lesions due to EHO around the hepaticojejunal anastomosis because they comprise small vessels in the mucosal surface and cannot be detected by contrast-enhanced computed tomography. Physicians need to insert the endoscope into the long afferent limb to diagnose angiodysplasia-like lesions around the hepaticojejunal anastomosis. Read More

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Transhepatic stent placement for malignant portal vein obstruction: Long term efficacy and factors associated with stent failure.

Eur J Radiol 2022 Apr 26;149:110230. Epub 2022 Feb 26.

Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea; Seoul National University College of Medicine, Seoul, Korea.

Purpose: To evaluate the long-term efficacy of transhepatic stentplacement in patients with symptomatic malignant portal vein(PV) obstruction and to identify risk factors for stent failure.

Methods: From April 2011 to March 2021, transhepatic stent placement was attempted in 36 patients with symptomatic malignant PV obstruction: naïve (n = 20) or recurrent tumor after surgery (n = 16). Technical success, clinical outcomes, and complications were retrospectively evaluated. Read More

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Transjugular intrahepatic portosystemic shunt for the treatment of portal hypertensive biliopathy with cavernous transformation of the portal vein: a case report.

BMC Gastroenterol 2022 Mar 3;22(1):96. Epub 2022 Mar 3.

Department of Gastroenterology and Hepatology, Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Background: Portal hypertensive biliopathy (PHB) was caused by anatomical and functional abnormalities in the intrahepatic and extrahepatic bile ducts secondary to portal hypertension. Currently, there is no consensus regarding to the optimal treatment for PHB. Transjugular intrahepatic portosystemic shunt (TIPS) is the treatment choice for the management of symptomatic PHB, however, it could be very difficult in patients with PHB and cavernous transformation of portal vein. Read More

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Superior mesenteric vein to the right testicular vein shunt operation for jejunal varices bleeding associated with extrahepatic portal vein obstruction after pancreaticoduodenectomy: a case report.

Surg Case Rep 2022 Feb 24;8(1):33. Epub 2022 Feb 24.

Department of Gastroenterological, Breast and Transplant Surgery, Hiroshima Prefectural Hospital, 1-5-54, Ujina-Kanda, Minami-ku, Hiroshima, 734-8530, Japan.

Background: Causes of extrahepatic portal vein obstruction include abdominal surgeries such as pancreaticoduodenectomy. We improved jejunal variceal bleeding due to extrahepatic portal vein occlusion after pancreaticoduodenectomy, by shunting of the testicular vein.

Case Presentation: A 72-year-old man was diagnosed with extrahepatic bile duct cancer and underwent subtotal stomach-preserving pancreaticoduodenectomy 5 years ago. Read More

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February 2022

Use of caudal pancreatectomy as a novel adjunct procedure to proximal splenorenal shunt in patients with noncirrhotic portal hypertension: A retrospective cohort study.

Ann Hepatobiliary Pancreat Surg 2022 May;26(2):178-183

Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Backgrounds/aims: Proximal splenorenal shunt (PSRS) is considered a one-time treatment for noncirrhotic portal hypertension (NCPH) to prevent recurrent upper gastrointestinal (UGI) hemorrhage and long-term complications. Long-term shunt patency is necessary to achieve these. The lie of the shunt is a contributing factor to early shunt thrombosis. Read More

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Hepatectomy for liver metastases from cervical cancer with portal vein tumor thrombosis: a case report.

Clin J Gastroenterol 2022 Apr 22;15(2):441-445. Epub 2022 Feb 22.

Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine (NCGM), 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.

The prognosis of patients with liver metastasis of cervical cancer is poor with an extremely short survival period, and there have been no reports of cervical cancer complicated by portal vein tumor thrombosis (PVTT). We report a case of cervical cancer developing liver metastasis with PVTT. A 49-year-old woman developed liver metastasis from cervical cancer with PVTT. Read More

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Intraductal papillary mucinous neoplasm of the pancreas presenting as a giant abdominal mass: A case report.

Ann Med Surg (Lond) 2022 Feb 19;74:103264. Epub 2022 Jan 19.

Surgical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco.

Introduction: Intraductal papillary mucinous neoplasms (IPMNs) constitute a group of rare conditions with a potential for malignant degeneration. The appearance of symptoms should suggest degeneration. This case demonstrates an unusual case of a patient presenting an intestinal type IPMN that was revealed by a large abdominal mass. Read More

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February 2022

Preliminary experience with continuous right ventricular pressure and transesophageal echocardiography monitoring in orthotopic liver transplantation.

PLoS One 2022 4;17(2):e0263386. Epub 2022 Feb 4.

Department of Anesthesiology and Critical Care Division, Montreal Heart Institute, Université de Montréal, Montréal, Canada.

Background: Despite increasing attention in the cardiac anesthesiology literature, continuous measurement of right ventricular pressure using a pulmonary artery catheter has not been described in orthotopic liver transplantation, despite similarities in the anesthetic approach to the two populations. We describe our preliminary experience with this technique in orthotopic liver transplantation, and by combining various derived measures with trans-esophageal echocardiography, make some early observations regarding the response of these measures of right ventricular function during the procedure.

Methods: In this case series, ten patients (five men and five women) undergoing orthotopic liver transplantation in our institution had their surgeries performed while monitored with a pulmonary artery catheter with continuous right ventricular port transduction and trans-esophageal echocardiography. Read More

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Letter to the editor: Is transjugular intrahepatic portosystemic shunt the best treatment for adults without cirrhosis with extrahepatic portal vein obstruction and portal hypertension?

Hepatology 2022 Jun 13;75(6):1667-1668. Epub 2022 Mar 13.

Division of Transplant and Advanced Hepatobiliary Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

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Hepatic veno-occlusive disease (sinusoidal obstruction syndrome) after hematopoietic stem cell transplantation in adult patients: Diagnosis, incidence, prophylaxis, and treatment.

Transfus Apher Sci 2022 Feb 22;61(1):103372. Epub 2022 Jan 22.

Yeditepe University Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Istanbul, Turkey.

Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) affecting the liver is a rare, possibly life-threatening complication of hematopoietic stem cell transplantation (HSCT). Sinusoidal endothelial cell (SEC) damage triggered by various factors (especially conditioning regimen) results in post sinusoidal portal hypertension due to obstruction of the hepatic vein. Diagnosis is guided by traditional clinical diagnostic criteria; the modified Seattle criteria, the Baltimore and revised European Group for Blood and Marrow Transplantation (EBMT), specifically. Read More

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February 2022

Portal Cavernoma Cholangiopathy in Children: An Evaluation Using Magnetic Resonance Cholangiography and Endoscopic Ultrasound.

J Clin Exp Hepatol 2022 Jan-Feb;12(1):135-143. Epub 2021 Mar 5.

Division of Paediatric Gastroenterology, Hepatology & Nutrition, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India.

Background: Portal cavernoma cholangiopathy (PCC) refers to abnormalities of the extra- and intrahepatic bile ducts in patients with portal cavernoma. The literature on PCC in children is very scarce. This study aimed at characterizing PCC in children with extrahepatic portal venous obstruction (EHPVO) using endoscopic ultrasound (EUS) and magnetic resonance cholangiography/portovenography (MRC/MRPV). Read More

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Do Natural Portosystemic Shunts Need to Be Compulsorily Ligated in Living Donor Liver Transplantation?

J Clin Exp Hepatol 2022 Jan-Feb;12(1):29-36. Epub 2021 Apr 24.

Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, 1, Press Enclave Road, Saket, New Delhi, 110017, India.

Background: Natural portosystemic shunt ligation practices in liver transplant vary widely across transplant centres and are frequently undertaken to prevent the serious consequence of portal steal phenomenon. No concrete indications have so far been convincingly identified for their management in living donor liver transplant.

Methods: We retrospectively studied the outcome of 89 cirrhotic patients who either did (n = 63) or did not (n = 25) undergo shunt ligation during living donor liver transplantation between 2017 and 2020. Read More

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Portal Vein Gas in Neonates: Predicting Clinical Treatment Outcomes From Ultrasound Findings.

J Ultrasound Med 2022 Jan 18. Epub 2022 Jan 18.

Department of Radiology, Haeundae Paik Hospital, Inje University, Busan, Korea.

Objectives: To identify sonographic findings that predict clinical outcomes in neonates with portal vein gas.

Methods: This retrospective study included neonates with portal vein gas detected using ultrasound (US). The US images were reviewed by a pediatric radiologist. Read More

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January 2022

Development of a Drum Tower Severity Scoring (DTSS) system for pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome.

Hepatol Int 2022 Jun 12;16(3):669-679. Epub 2022 Jan 12.

Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321#, Zhongshan Road, Nanjing, 210008, Jiangsu, China.

Background And Aims: There has been no reliable severity system based on the prognosis to guide therapeutic strategies for patients with pyrrolizidine alkaloid (PA)-induced hepatic sinusoidal obstruction syndrome (HSOS). We aimed to create a novel Drum Tower Severity Scoring (DTSS) system for these patients to guide therapy.

Methods: 172 Patients with PA-HSOS who received supportive care and anticoagulation therapy in Nanjing Drum Tower Hospital from January 2008 to December 2020 were enrolled and analyzed retrospectively. Read More

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Magnetic-assisted laparoscopic liver transplantation in swine.

Hepatobiliary Pancreat Dis Int 2021 Dec 31. Epub 2021 Dec 31.

Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, Institute of Advanced Surgical Technology and Engineering, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China. Electronic address:

Background: Although laparoscopic technology has achieved rapid development in the surgical field, it has not been applied to liver transplantation, primarily because of difficulties associated with laparoscopic vascular anastomosis. In this study, we introduced a new magnetic-assisted vascular anastomosis technique and explored its application in laparoscopic liver transplantation in pigs.

Methods: Two sets of magnetic vascular anastomosis rings (MVARs) with different diameters were developed. Read More

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December 2021

Duodenal obstruction due to missed pre-duodenal portal vein in a patient with intestinal malrotation.

Afr J Paediatr Surg 2022 Apr-Jun;19(2):109-111

Department of Surgery, College of Medicine, Kaduna State University and Barau Dikko Teaching Hospital, Kaduna, Nigeria.

Pre-duodenal portal vein (PDPV) is a rare anomaly and a rare cause of duodenal obstruction (DO), with only a few cases reported in the literature. We present an infant whose bilious vomiting persisted despite having Ladd's procedure for intestinal malrotation due to a missed diagnosis of DO from PDPV that was found at re-exploration. The patient was diagnosed with malrotation and had Ladd's procedure at 12 weeks of age, but bilious vomiting persisted post-operatively. Read More

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January 2022

Hepatic venoocclusive disease/sinusoidal obstruction syndrome with normal portal vein flow mimicking aggravated chronic hepatic GVHD following inotuzumab ozogamicin salvage therapy: a case report of pathologic-radiologic discrepancy.

Ther Adv Hematol 2021 21;12:20406207211066176. Epub 2021 Dec 21.

Department of Hematology, Catholic Hematology Hospital and Leukemia Research Institute, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea.

Inotuzumab ozogamicin (INO) showed improved treatment outcomes for relapsed or refractory B-cell precursor acute lymphoblastic leukemia (BCP-ALL) but can induce hepatotoxic adverse events. Hepatic venoocclusive disease/sinusoidal obstruction syndrome (VOD/SOS) frequently develops after allogeneic hematopoietic cell transplantation (allo-HCT), and INO is a strong pretransplant risk factor. However, VOD/SOS can occur just after INO therapy. Read More

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December 2021

Long term outcomes of hepatic resection following orthotopic liver transplant.

ANZ J Surg 2022 03 19;92(3):526-530. Epub 2021 Dec 19.

Transplant Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

Background: Liver resection is sometimes used as a graft saving procedure following orthotopic liver transplantation.

Methods: In this single centre retrospective cohort study, 12 adult patients underwent resection over a 20 year period, including recipients of split livers and second grafts.

Results: Indications for resection were vascular (portal vein obstruction and hepatic artery thrombus), biliary (ischaemic cholangiopathy, chronic biliary obstruction, biliary-vascular fistula and biloma) and recurrence of disease (primary sclerosing cholangitis [PSC] and hepatocellular carcinoma [HCC]). Read More

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Rex Shunt for Portal Vein Thrombosis After Pediatric Living Donor Liver Transplantation.

Ann Transplant 2021 Dec 15;26:e909493. Epub 2021 Dec 15.

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan.

BACKGROUND Portal vein thrombosis (PVT) after pediatric liver transplantation (LT) is a common but grave complication which could eventually result in life-threatening portal hypertension. A "Rex" shunt between the superior mesenteric vein and the Rex recess of the liver has been reported to be a treatment option for extrahepatic portal vein obstruction; however, its application to living donor liver transplantation (LDLT) is limited due to the availability of appropriate vein grafts. In this study, we retrospectively evaluated the effectiveness of Rex shunt as an option for the treatment of PVT after pediatric LDLT. Read More

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December 2021