Mesenterico-left intrahepatic portal vein shunt: Original technique to treat symptomatic extrahepatic portal hypertension

J. De Ville De Goyet, J. P. Martinet, M. Lacrosse, R. Goffette, M. Melange, J. Lerut

Research output: Contribution to journalArticle

Abstract

Mesenterico-left intrahepatic portal vein shunt: original technique to treat symptomatic extrahepatic portal hypertension. Objective: Revascularization of the intrahepatic portal system as decompressive surgery for chronic extrahepatic portal hypertension. Summary background data: In patients with extrahepatic portal hypertension (portal trunk thrombosis in presence of a normal liver), shunt surgery is indicated when patient is bleeding from varices at a site not accessible for the endoscopist. Although surgical portal decompression is an efficient procedure, there is a risk of depriving the liver from the splanchnic venous flow and a risk of developing porto-systemic shunt related side effects. Method: A shunt was created between the superior mesenteric vein and the umbilical portion of the left portal vein. This technique allows to bypass the thrombosed portion of the portal vein but avoiding dissection of the cavernoma in the liver hilum and related risk of intraoperative hemorrhage. Results: The procedure was successfully performed in one adult patient considered unshuntable in view of classic surgical procedures and in whom sclerotherapy was unsuccessful. This operation achieved an effective decompression of the splanchnic venous system. Conclusion: Rerouting the venous splanchnic flow through the liver was possible. It had the major physiological advantage of restoring the normal hepatic vascularization. It also avoided putting the patient at risk of developing porto-systemic shunt related side effects. This option should be considered when shunt procedures are indicated in patients with extrahepatic portal hypertension.

Original languageEnglish
Pages (from-to)13-16
Number of pages4
JournalActa Gastro-Enterologica Belgica
Volume61
Issue number1
Publication statusPublished - Jan 1998

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Keywords

  • Extrahepatic
  • Mesenterico-portal bypass
  • Portal hypertension
  • Portal vein thrombosis
  • Surgical technique

ASJC Scopus subject areas

  • Gastroenterology

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