Small-diameter mesocaval shunts: A 10-year evaluation

Mercado, Miguel Ángel; Orozco, Héctor; Guillén-Navarro, Erika; Acosta, Erik; López-Martínez, Luz María; Hinojosa, Carlos A.; Hernández, Jorge; Tielve, M

doi:10.1016/s1091-255x(00)80085-2

Cited by 19 publications

(11 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mesocaval shunt is a small-diameter shunt and can be applied with or without PTFE interposition. Results differ, with a rebleeding rate of 5-15% and a patency of 81-95% [43,44]. It is a good alternative in cases of noncirrhotic PVT and patent superior mesenteric vein when the splenic and portal veins are occluded.…”

Section: Noncirrhotic Pvtmentioning

confidence: 99%

Update on Shunt Surgery

2020

View full text Add to dashboard Cite

Background: Bleeding from esophagogastric varices is a life-threatening complication from portal hypertension. It occurs in 15% of patients and has a mortality rate of 20–35%. Summary: The primary therapy for variceal bleeding is medical. In cases of recurrent bleeding, a definitive therapy is required. In cases of parenchymal decompensation, liver transplantation is the causal therapy, but if liver function is preserved, portal decompression is the therapy of choice. The use of the transjugular intrahepatic portosystemic shunt (TIPS) has achieved widespread acceptance, although evidence for surgical shunts is comparable or better in patients with good hepatic reserve. The type of surgical shunt depends on the patent veins of the portomesenteric system. If total occlusion is present, a devascularization procedure might be indicated. Key Messages: Therapy, taking into account liver function, morphology of the portovenous system, and imminent liver transplantation, should be performed by an interdisciplinary team of gastroenterologists, interventional radiologists, and gastrointestinal surgeons.

show abstract

Section: Noncirrhotic Pvtmentioning

confidence: 99%

Update on Shunt Surgery

2020

View full text Add to dashboard Cite

show abstract

“…In the context of diffuse thrombosis in the portal, splenic, and superior mesenteric veins, previously described conventional shunts were not feasible. 1,2,5,6 The outflow of the mesentery had to be restored; otherwise, liver or multivisceral transplantation might have been necessary to prevent further complications secondary to diffuse thrombosis in the portomesenteric system. Our technique of triple surgical mesosystemic shunting, including a mesorenal shunt using the saphenous vein graft and mesocaval shunts using both sides of gonadal veins, was effective and successful in restoring intestinal venous outflow.…”

Section: Postoperative Coursementioning

confidence: 99%

“…In this setting, surgical shunts have played a major role in the management of patients with portal hypertension and bleeding gastrointestinal varices. [1][2][3] Another option for diffuse mesenteric thrombosis is organ transplantation. However, this is a major undertaking in which the recipient's portomesenteric venous system is completely replaced via multivisceral transplantation.…”

mentioning

confidence: 99%

Emergent nonconventional mesosystemic shunt for diffuse portomesenteric thrombosis: Sparing patients from liver/multivisceral transplantation

et al. 2013

View full text Add to dashboard Cite

“…Portal vein thrombosis (PVT) is a significant postoperative complication in patients with portal hypertension, and procedures such as devascularization, portal systemic shunt and liver transplantation can cause PVT [1][2][3] . As the degree of obstruction and location vary greatly, the clinical manifestations of PVT are also highly variable [4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Predictive value of D-dimer for portal vein thrombosis after portal hypertension surgery in hepatitis B virus-related cirrhosis

Deng¹

2007

WJG

View full text Add to dashboard Cite

AIM:To evaluate the predictive value of D-dimer as a predictive indicator of portal vein thrombosis (PVT) after portal hypertension surgery in hepatitis B virus-related cirrhosis. METHODS:A prospective study was carried out in 52 patients who had undergone surgery for portal hypertension in hepatitis B virus-related cirrhosis. Changes in perioperative dynamic D-dimer were observed. The sensitivity, specificity, positive predictive values and negative predictive values of D-dimer were calculated, and ROC curves were analyzed. RESULTS:The D-dimer levels in the group developing postoperative PVT was significantly higher than those in the group not developing PVT (P = 0.001), and the ROC semi-quantitative and qualitative analysis of D-dimer showed a moderate predictive value in PVT (semiquantitative value Az = 0.794, P = 0.000; qualitative analysis: Az = 0.739, P = 0.001). CONCLUSION:Dynamic monitoring of D-dimer levels in patients with portal hypertension after surgery can help early diagnosis of PVT, as in cases where the D-dimer levels steadily increase and exceed 16 µg/mL, the possibility of PVT is very high.

show abstract

Small-diameter mesocaval shunts: A 10-year evaluation

Cited by 19 publications

References 13 publications

Update on Shunt Surgery

Update on Shunt Surgery

Emergent nonconventional mesosystemic shunt for diffuse portomesenteric thrombosis: Sparing patients from liver/multivisceral transplantation

Predictive value of D-dimer for portal vein thrombosis after portal hypertension surgery in hepatitis B virus-related cirrhosis

Contact Info

Product

Resources

About