Journal of Pediatric Surgery
Volume 44, Issue 11 , Pages 2067-2070 , November 2009

Growth impairment in children with extrahepatic portal vein obstruction is improved by mesenterico-left portal vein bypass

  • Timothy B. Lautz

      Affiliations

    • Department of Surgery, Children's Memorial Hospital, Feinberg School of Medicine of Northwestern University, Chicago, IL 60611, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 312 282 5761; fax: +1 312 926 7404.
    • ,
  • Shikha S. Sundaram

      Affiliations

    • Department of Gastroenterology, Children's Memorial Hospital, Feinberg School of Medicine of Northwestern University, Chicago, IL 60611, USA
    • ,
  • Peter F. Whitington

      Affiliations

    • Department of Gastroenterology, Children's Memorial Hospital, Feinberg School of Medicine of Northwestern University, Chicago, IL 60611, USA
    • ,
  • Lisa Keys

      Affiliations

    • Department of Surgery, Children's Memorial Hospital, Feinberg School of Medicine of Northwestern University, Chicago, IL 60611, USA
    • ,
  • Riccardo A. Superina

      Affiliations

    • Department of Surgery, Children's Memorial Hospital, Feinberg School of Medicine of Northwestern University, Chicago, IL 60611, USA

Received 18 April 2009 ,Revised 12 May 2009 ,Accepted 13 May 2009.

References 

  1. Alonso EM, Hackworth C, Whitington PF. Portal hypertension in children. Clin Liver Dis. 1997;1:201–222
  2. Alvarez F, Bernard O, Brunelle F, et al. Portal obstruction in children. I. Clinical investigation and hemorrhage risk. J Pediatr. 1983;103:696–702
  3. Alvarez F, Bernard O, Brunelle F, et al. Portal obstruction in children. II. Results of surgical portosystemic shunts. J Pediatr. 1983;103:703–707
  4. Superina RA, Alonso EM. Medical and surgical management of portal hypertension in children. Curr Treat Options Gastroenterol. 2006;9:432–443
  5. Shilyansky J, Roberts EA, Superina RA. Distal splenorenal shunts for the treatment of severe thrombocytopenia from portal hypertension in children. J Gastrointest Surg. 1999;3:167–172
  6. Shneider B, Emre S, Groszmann R, et al. Expert pediatric opinion on the report of the Baveno IV consensus workshop on methodology of diagnosis and therapy in portal hypertension. Pediatr Transplant. 2006;10:893–907
  7. Superina R, Shneider B, Emre S, et al. Surgical guidelines for the management of extra-hepatic portal vein obstruction. Pediatr Transplant. 2006;10:908–913
  8. Bambini DA, Superina R, Almond PS, et al. Experience with the Rex shunt (mesenterico-left portal bypass) in children with extrahepatic portal hypertension. J Pediatr Surg. 2000;35:13–18
  9. de Ville de Goyet J, Alberti D, Falchetti D, et al. Treatment of extrahepatic portal hypertension in children by mesenteric-to-left portal vein bypass: a new physiological procedure. Eur J Surg. 1999;165:777–781
  10. de Ville de Goyet J, Gibbs P, Clapuyt P, et al. Original extrahilar approach for hepatic portal revascularization and relief of extrahepatic portal hypertension related to later portal vein thrombosis after pediatric liver transplantation. Long term results. Transplantation. 1996;62:71–75
  11. Superina R, Bambini DA, Lokar J, et al. Correction of extrahepatic portal vein thrombosis by the mesenteric to left portal vein bypass. Ann Surg. 2006;243:515–521
  12. Mack CL, Superina RA, Whitington PF. Surgical restoration of portal flow corrects procoagulant and anticoagulant deficiencies associated with extrahepatic portal vein thrombosis. J Pediatr. 2003;142:197–199
  13. Mack CL, Zelko FA, Lokar J, et al. Surgically restoring portal blood flow to the liver in children with primary extrahepatic portal vein thrombosis improves fluid neurocognitive ability. Pediatrics. 2006;117:e405–e412
  14. Sarin SK, Bansal A, Sasan S, et al. Portal-vein obstruction in children leads to growth retardation. Hepatology. 1992;15:229–233
  15. Menon P, Rao KL, Bhattacharya A, et al. Extrahepatic portal hypertension: quality of life and somatic growth after surgery. Eur J Pediatr Surg. 2005;15:82–87
  16. Mehrotra RN, Bhatia V, Dabadghao P, et al. Extrahepatic portal vein obstruction in children: anthropometry, growth hormone, and insulin-like growth factor I. J Pediatr Gastroenterol Nutr. 1997;25:520–523
  17. Stringer MD. Improved body mass index after mesenterico-portal bypass. Pediatr Surg Int. 2007;23:539–543
  18. Assaad SN, Cunningham GR, Samaan NA. Abnormal growth hormone dynamics in chronic liver disease do not depend on severe parenchymal disease. Metabolism. 1990;39:349–356
  19. Chiu B, Melin-Aldana H, Pillai S, et al. Factor VII transcription correlates with hepatocyte proliferation and hepatocyte growth factor expression in a rodent extrahepatic portal vein obstruction model. J Am Coll Surg. 2007;205:277–283
  20. Chiu B, Melin-Aldana H, Pillai S, et al. Extrahepatic portal vein obstruction results in hepatocyte proliferation but a decrease in protein-C synthesis. J Pediatr Surg. 2007;42:796–799
  21. Chiu B, Melin-Aldana H, Superina RA. Human extrahepatic portal vein obstruction correlates with decreased factor VII and protein C transcription but increased hepatocyte proliferation. J Pediatr Surg. 2007;42:1768–1771

PII: S0022-3468(09)00412-6

doi: 10.1016/j.jpedsurg.2009.05.016

Journal of Pediatric Surgery
Volume 44, Issue 11 , Pages 2067-2070 , November 2009

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