Correction of extrahepatic portal vein thrombosis by the mesenteric to left portal vein bypass
The goal of this study was to determine the effectiveness of mesenteric vein to left portal vein bypass operation (MLPVB) in correcting extrahepatic portal vein thrombosis (EHPVT) in children. The treatment of idiopathic EHPVT has been primarily palliative, whereas MLPVB restores hepatic portal flow...
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| Veröffentlicht in: | Annals of surgery 2006-04, Vol.243 (4), p.515-521 |
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| creator | SUPERINA, Riccardo BAMBINI, Daniel A LOKAR, Joan RIGSBY, Cynthia WHITINGTON, Peter F |
| description | The goal of this study was to determine the effectiveness of mesenteric vein to left portal vein bypass operation (MLPVB) in correcting extrahepatic portal vein thrombosis (EHPVT) in children. The treatment of idiopathic EHPVT has been primarily palliative, whereas MLPVB restores hepatic portal flow in patients with EHPVT.
Thirty-four children with symptomatic EHPVT underwent surgery with intent to perform MLPVB and were followed for up to 7 years. MLPVB was successful in 31 patients (91%), all of whom maintain patent vein grafts and have symptomatic relief of EHPVT in follow-up. All patients had complete relief from gastrointestinal bleeding. Patients with hypersplenism had significant increases in platelet and leukocyte counts and reduction in spleen size. Superior mesenteric vein flow increased from 119 +/- 66 mL/min before bypass to 447 +/- 225 mL/min (P < 0.0001) after surgery. Postoperative blood flow in the bypass graft expressed as a fraction of calculated ideal portal flow for size correlated inversely with age (P < 0.001). Left-portal vein diameter increased from 2.6 +/- 1.6 mm to 7.3 +/- 2.4 mm 2 years after surgery (P < 0.002). Liver volume increased from 703 +/- 349 cm3 to 799 +/- 351 cm3 1 week after surgery (P < 0.001). Prothrombin time improved to normal in all patients 1 year after surgery.
MLPVB provides excellent relief of symptoms in children with idiopathic EHPVT and results in liver growth and normalization of coagulation parameters. This surgery is corrective and should be done at as early an age as possible. |
| doi_str_mv | 10.1097/01.sla.0000205827.73706.97 |
| format | Article |
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Thirty-four children with symptomatic EHPVT underwent surgery with intent to perform MLPVB and were followed for up to 7 years. MLPVB was successful in 31 patients (91%), all of whom maintain patent vein grafts and have symptomatic relief of EHPVT in follow-up. All patients had complete relief from gastrointestinal bleeding. Patients with hypersplenism had significant increases in platelet and leukocyte counts and reduction in spleen size. Superior mesenteric vein flow increased from 119 +/- 66 mL/min before bypass to 447 +/- 225 mL/min (P < 0.0001) after surgery. Postoperative blood flow in the bypass graft expressed as a fraction of calculated ideal portal flow for size correlated inversely with age (P < 0.001). Left-portal vein diameter increased from 2.6 +/- 1.6 mm to 7.3 +/- 2.4 mm 2 years after surgery (P < 0.002). Liver volume increased from 703 +/- 349 cm3 to 799 +/- 351 cm3 1 week after surgery (P < 0.001). Prothrombin time improved to normal in all patients 1 year after surgery.
MLPVB provides excellent relief of symptoms in children with idiopathic EHPVT and results in liver growth and normalization of coagulation parameters. This surgery is corrective and should be done at as early an age as possible.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/01.sla.0000205827.73706.97</identifier><identifier>PMID: 16552203</identifier><identifier>CODEN: ANSUA5</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Biological and medical sciences ; Blood Pressure ; Child ; Child, Preschool ; Gastrointestinal Hemorrhage - etiology ; General aspects ; Humans ; Hypersplenism - etiology ; Hypertension, Portal - etiology ; Infant ; Leukocyte Count ; Liver Function Tests ; Male ; Medical sciences ; Mesenteric Veins - surgery ; Original ; Platelet Count ; Portal Vein - surgery ; Retrospective Studies ; Vascular Surgical Procedures ; Venous Thrombosis - complications ; Venous Thrombosis - surgery</subject><ispartof>Annals of surgery, 2006-04, Vol.243 (4), p.515-521</ispartof><rights>2006 INIST-CNRS</rights><rights>2006 Lippincott Williams & Wilkins, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c454t-57d6c5c79ce29905cc995594b6bbf6e4dc5736ab355c4f2b7b5440e389b574eb3</citedby><cites>FETCH-LOGICAL-c454t-57d6c5c79ce29905cc995594b6bbf6e4dc5736ab355c4f2b7b5440e389b574eb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448975/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448975/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17664526$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16552203$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SUPERINA, Riccardo</creatorcontrib><creatorcontrib>BAMBINI, Daniel A</creatorcontrib><creatorcontrib>LOKAR, Joan</creatorcontrib><creatorcontrib>RIGSBY, Cynthia</creatorcontrib><creatorcontrib>WHITINGTON, Peter F</creatorcontrib><title>Correction of extrahepatic portal vein thrombosis by the mesenteric to left portal vein bypass</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>The goal of this study was to determine the effectiveness of mesenteric vein to left portal vein bypass operation (MLPVB) in correcting extrahepatic portal vein thrombosis (EHPVT) in children. The treatment of idiopathic EHPVT has been primarily palliative, whereas MLPVB restores hepatic portal flow in patients with EHPVT.
Thirty-four children with symptomatic EHPVT underwent surgery with intent to perform MLPVB and were followed for up to 7 years. MLPVB was successful in 31 patients (91%), all of whom maintain patent vein grafts and have symptomatic relief of EHPVT in follow-up. All patients had complete relief from gastrointestinal bleeding. Patients with hypersplenism had significant increases in platelet and leukocyte counts and reduction in spleen size. Superior mesenteric vein flow increased from 119 +/- 66 mL/min before bypass to 447 +/- 225 mL/min (P < 0.0001) after surgery. Postoperative blood flow in the bypass graft expressed as a fraction of calculated ideal portal flow for size correlated inversely with age (P < 0.001). Left-portal vein diameter increased from 2.6 +/- 1.6 mm to 7.3 +/- 2.4 mm 2 years after surgery (P < 0.002). Liver volume increased from 703 +/- 349 cm3 to 799 +/- 351 cm3 1 week after surgery (P < 0.001). Prothrombin time improved to normal in all patients 1 year after surgery.
MLPVB provides excellent relief of symptoms in children with idiopathic EHPVT and results in liver growth and normalization of coagulation parameters. This surgery is corrective and should be done at as early an age as possible.</description><subject>Biological and medical sciences</subject><subject>Blood Pressure</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Gastrointestinal Hemorrhage - etiology</subject><subject>General aspects</subject><subject>Humans</subject><subject>Hypersplenism - etiology</subject><subject>Hypertension, Portal - etiology</subject><subject>Infant</subject><subject>Leukocyte Count</subject><subject>Liver Function Tests</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mesenteric Veins - surgery</subject><subject>Original</subject><subject>Platelet Count</subject><subject>Portal Vein - surgery</subject><subject>Retrospective Studies</subject><subject>Vascular Surgical Procedures</subject><subject>Venous Thrombosis - complications</subject><subject>Venous Thrombosis - surgery</subject><issn>0003-4932</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkdGK1DAUhoMo7uzqK0gR9K41SZOcxgthGVwVFrzRW0OSOXUibVOTzOK8vdEdHDc3IeT7_3PgI-Qlox2jGt5Q1uXJdrQeTuXAoYMeqOo0PCIbJvnQMiboY7KpQN8K3fMLcpnzD0qZGCg8JRdMSck57Tfk2zamhL6EuDRxbPBXSXaPqy3BN2tMxU7NHYalKfsUZxdzyI071hc2M2ZcCqYKlthMOJYHAXdcbc7PyJPRThmfn-4r8vXm_Zftx_b284dP2-vb1gspSithp7z0oD1yran0XmsptXDKuVGh2HkJvbKul9KLkTtwUgiK_aCdBIGuvyLv7nvXg5tx5-tmyU5mTWG26WiiDebhzxL25nu8M0yIQYOsBa9PBSn-PGAuZg7Z4zTZBeMhGwUADKSu4Nt70KeYc8Lx3xBGzR89hjJT9ZizHvNXj9FQwy_-X_McPfmowKsTYLO305js4kM-c6CUkFz1vwEUYpx7</recordid><startdate>20060401</startdate><enddate>20060401</enddate><creator>SUPERINA, Riccardo</creator><creator>BAMBINI, Daniel A</creator><creator>LOKAR, Joan</creator><creator>RIGSBY, Cynthia</creator><creator>WHITINGTON, Peter F</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20060401</creationdate><title>Correction of extrahepatic portal vein thrombosis by the mesenteric to left portal vein bypass</title><author>SUPERINA, Riccardo ; BAMBINI, Daniel A ; LOKAR, Joan ; RIGSBY, Cynthia ; WHITINGTON, Peter F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c454t-57d6c5c79ce29905cc995594b6bbf6e4dc5736ab355c4f2b7b5440e389b574eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Biological and medical sciences</topic><topic>Blood Pressure</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Gastrointestinal Hemorrhage - etiology</topic><topic>General aspects</topic><topic>Humans</topic><topic>Hypersplenism - etiology</topic><topic>Hypertension, Portal - etiology</topic><topic>Infant</topic><topic>Leukocyte Count</topic><topic>Liver Function Tests</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mesenteric Veins - surgery</topic><topic>Original</topic><topic>Platelet Count</topic><topic>Portal Vein - surgery</topic><topic>Retrospective Studies</topic><topic>Vascular Surgical Procedures</topic><topic>Venous Thrombosis - complications</topic><topic>Venous Thrombosis - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SUPERINA, Riccardo</creatorcontrib><creatorcontrib>BAMBINI, Daniel A</creatorcontrib><creatorcontrib>LOKAR, Joan</creatorcontrib><creatorcontrib>RIGSBY, Cynthia</creatorcontrib><creatorcontrib>WHITINGTON, Peter F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SUPERINA, Riccardo</au><au>BAMBINI, Daniel A</au><au>LOKAR, Joan</au><au>RIGSBY, Cynthia</au><au>WHITINGTON, Peter F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correction of extrahepatic portal vein thrombosis by the mesenteric to left portal vein bypass</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>2006-04-01</date><risdate>2006</risdate><volume>243</volume><issue>4</issue><spage>515</spage><epage>521</epage><pages>515-521</pages><issn>0003-4932</issn><eissn>1528-1140</eissn><coden>ANSUA5</coden><abstract>The goal of this study was to determine the effectiveness of mesenteric vein to left portal vein bypass operation (MLPVB) in correcting extrahepatic portal vein thrombosis (EHPVT) in children. The treatment of idiopathic EHPVT has been primarily palliative, whereas MLPVB restores hepatic portal flow in patients with EHPVT.
Thirty-four children with symptomatic EHPVT underwent surgery with intent to perform MLPVB and were followed for up to 7 years. MLPVB was successful in 31 patients (91%), all of whom maintain patent vein grafts and have symptomatic relief of EHPVT in follow-up. All patients had complete relief from gastrointestinal bleeding. Patients with hypersplenism had significant increases in platelet and leukocyte counts and reduction in spleen size. Superior mesenteric vein flow increased from 119 +/- 66 mL/min before bypass to 447 +/- 225 mL/min (P < 0.0001) after surgery. Postoperative blood flow in the bypass graft expressed as a fraction of calculated ideal portal flow for size correlated inversely with age (P < 0.001). Left-portal vein diameter increased from 2.6 +/- 1.6 mm to 7.3 +/- 2.4 mm 2 years after surgery (P < 0.002). Liver volume increased from 703 +/- 349 cm3 to 799 +/- 351 cm3 1 week after surgery (P < 0.001). Prothrombin time improved to normal in all patients 1 year after surgery.
MLPVB provides excellent relief of symptoms in children with idiopathic EHPVT and results in liver growth and normalization of coagulation parameters. This surgery is corrective and should be done at as early an age as possible.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>16552203</pmid><doi>10.1097/01.sla.0000205827.73706.97</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Biological and medical sciences Blood Pressure Child Child, Preschool Gastrointestinal Hemorrhage - etiology General aspects Humans Hypersplenism - etiology Hypertension, Portal - etiology Infant Leukocyte Count Liver Function Tests Male Medical sciences Mesenteric Veins - surgery Original Platelet Count Portal Vein - surgery Retrospective Studies Vascular Surgical Procedures Venous Thrombosis - complications Venous Thrombosis - surgery |
| title | Correction of extrahepatic portal vein thrombosis by the mesenteric to left portal vein bypass |
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