The authors declare that they have no competing interests.
Concept and design, HTY, KKM, CYP, LSG; Analysis and interpretation of data, HTY, KKM, KGY, OSH, CYP, LSG; Drafting the paper, HTY, KKM, CYP, LSG; Data collection: KKM, OSH, KTW, CYP; Writing, HTY, KKM, OSH, CYP, LSG; Review, HTY, KKM, KGY, OSH, KTW, CYP, LSG. All the authors approved of the submitted and final versions.
The aim of this study was to evaluate whether variant meso-Rex bypass with transposition of abdominal autogenous vein can be used as an alternative treatment modality for selected patients with symptomatic extrahepatic portal vein obstruction.
This was a retrospective review of six consecutive patients who received this alternative procedure for the treatment of symptomatic portal hypertension secondary to idiopathic extrahepatic portal vein obstruction. Their clinical characteristics, operative procedures and outcomes were analyzed retrospectively.
The procedure was attempted in six patients, and all had a patent shunt established by intraoperative portography at the end of the procedure; the coronary vein was used in four patients and the inferior mesenteric vein was used in two. During the median period of 23.5 months (range 10–30 months), follow-up was uneventful except one patient; reduced portal hypertension and no new episodes of gastrointestinal bleeding were observed in all patients, with the exception of one patient with shunt stenosis and recurrent varix bleeding who had to undergo endovascular treatment to restore portal vein blood flow. Technical and clinical success was achieved in all patients.
This procedure could be used safely and effectively to treat selected patients with portal hypertension secondary to extrahepatic portal vein obstruction.
de Ville de Goyet J, Lo Zupone C, Grimaldi C, D'Ambrosio G, Candusso M, Torre G, et al. Meso-Rex bypass as an alternative technique for portal vein reconstruction at or after liver transplantation in children: Review and perspectives. Pediatr Transplant. 2013;17:19–26. CrossRef
de Ville de Goyet J, Clapuyt P, Otte JB. Extrahilar mesentericoleft portal shunt to relieve extrahepatic portal hypertension after partial liver transplant. Transplantation. 1992;53:231–2.
de Ville de Goyet J, Alberti D, Falchetti D, Rigamonti W, Matricardi L, Clapuyt P, et al. Treatment of extrahepatic portal hypertension in children by mesenteric-to-left portal vein bypass: a new physiological procedure. Eur J Surg. 1999;165:777–81. CrossRef
- Variant meso-Rex bypass with transposition of abdominal autogenous vein for the management of idiopathic extrahepatic portal vein obstruction: a retrospective observational study
Seak Hee Oh
- BioMed Central
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