D'Cruz A J, Kamath P S, Ramachandra C, Jalihal A
Department of Pediatric Surgery, St John's Medical College Hospital, Bangalore, India.
Acta Paediatr Jpn. 1995 Feb;37(1):17-20. doi: 10.1111/j.1442-200x.1995.tb03678.x.
Portal hypertension due to extrahepatic portal vein obstruction is ideally treated by the use of a selective shunt. In a four year period between July 1987 and June 1992, 50 surgical procedures were carried out in 48 children with portal hypertension-related variceal hemorrhage. The portal, splenic, mesenteric, or coronary vein was not available for anastomosis in four children who, therefore, underwent non-conventional shunts which are described here. There was no postoperative mortality. One patient had a repeat gastrointestinal hemorrhage, probably due to stenosis of the shunt and failure to ligate the coronary vein. No rebleeding occurred on follow-up of at least 18 months. We conclude that in selected children requiring surgery for portal hypertension due to extrahepatic portal venous obstruction, a non-conventional shunt may be used with beneficial results.
肝外门静脉阻塞所致的门静脉高压症，理想的治疗方法是采用选择性分流术。在1987年7月至1992年6月的四年间，对48例患有门静脉高压相关静脉曲张出血的儿童进行了50次外科手术。4名儿童无法进行门静脉、脾静脉、肠系膜静脉或冠状静脉吻合，因此接受了本文所述的非常规分流术。术后无死亡病例。1例患者再次发生胃肠道出血，可能是由于分流狭窄且未结扎冠状静脉所致。至少随访18个月未再出血。我们得出结论，对于因肝外门静脉阻塞而需要手术治疗门静脉高压的特定儿童，可采用非常规分流术，效果良好。
