Department of Transplant Surgery, National Center for Child Health and Development, Setagaya-ku, Tokyo, 157-8535, Japan.
J Pediatr Surg. 2011 Jun;46(6):e19-22. doi: 10.1016/j.jpedsurg.2011.03.077.
Portosystemic shunts may cause steal phenomenon after liver transplantation, which can lead to graft loss without proper management. Portal vein stenosis is one of the causes for the occurrence of portosystemic shunts after liver transplantation. Recently, new interventional radiologic techniques have been developed in the field of liver transplantation. Balloon-occluded retrograde transvenous obliteration (B-RTO) is a novel interventional technique for gastric varices and portosystemic shunts and also is effective for increasing portal vein flow. We herein report a pediatric case of portal vein stenosis with a large shunt successfully treated with a combination of balloon dilatation and B-RTO. If enlarged collateral vessels cause steal phenomenon, then B-RTO should be considered as an additional therapy.
门体分流可能会导致肝移植后出现窃血现象，如果不加以适当的管理，可能会导致移植物丢失。门脉狭窄是肝移植后门体分流发生的原因之一。最近，肝移植领域发展了新的介入放射学技术。球囊闭塞逆行经静脉栓塞术（B-RTO）是一种治疗胃静脉曲张和门体分流的新介入技术，也可有效增加门静脉血流。本文报告了一例儿童门脉狭窄伴大分流病例，采用球囊扩张和 B-RTO 联合治疗获得成功。如果增大的侧支血管导致窃血现象，则应考虑将 B-RTO 作为附加治疗。
