DETERMINATION OF PORTAL BLOOD OPTIMAL SHUNTING VOLUME PRIOR TO THE SURGERY IN EXTRAHEPATIC PORTAL HYPERTENSION

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Abstract

Purpose of the study: to determine the necessary shunt diameter and optimal shunting volume of portal blood in children with extrahepatic portal hypertension prior to portosystemic shunting. Methods of the study: a complex ultrasound examination was carried out (B mode in real time and duplex scanning in color flow mapping mode). Changes in the liver hemodynamics before and after portosystemic shunting were examined. In 30 children the surgery was done without determination of the necessary shunt diameter. Determination of diameter, speed characteristics and blood flow in the vessels of the portal system, hepatic and splenic arteries was done in 51 patients prior to the surgery to determine the necessary shunting volume. Material performance: 106 children aged 4 to 7 were examined. 25 of them were healthy and 81 children had extrahepatic portal hypertension. Results: it was established that before portosystemic shunting in patients with extrahepatic portal hypertension it is necessary to determine the diameter of the shunt and volume of blood shunting needed to preserve the portal blood flow in the liver and decrease the pressure in the portal system effectively. Conclusion: portosystemic shunting decreases the portal pressure, preserves hepatic hemodynamics and prevents esophagogastric hemorrhages in patients with extrahepatic portal hypertension with individual determination of the necessary volume of blood shunting.

About the authors

N. A. Ranchaeva

State Budgetary Educational Institution of Higher Professional Education Krasnoyarsk Medical University named after professor V.F. Voyno-Yasenetsky of the Ministry of Health of Russia; Territorial Government-Owned Publicly Funded Health Care Institution Territorial Interdistrict Clinical Hospital No. 20 named after I.S.Berzon

Author for correspondence.
Email: freeda-ego@mail.ru
Россия

V. A. Yurchuk

State Budgetary Educational Institution of Higher Professional Education Krasnoyarsk Medical University named after professor V.F. Voyno-Yasenetsky of the Ministry of Health of Russia

Email: noemail@neicon.ru
Россия

References

  1. Ерамишанцев А.К., Манукьян Г.В. Портальная гипертензия и желудочно-кишечные кровотечения // Болезни печени и желчевыводящих путей: руководство для врачей / под ред. В.Т. Ивашкина. 2-е изд. - М.: ООО «Изд. дом «М-Вести», 2005. С. 234-251.
  2. Зурбаев Н.Т., Сенякович В.М. Сравнительный анализ результатов разных вариантов спленоренального шунтирования у детей с внутрипеченочной портальной гипертензией // Детская хирургия. 2005. № 57. С. 18-24.
  3. Леонтьев А.Ф. Внепеченочная портальная гипертензия у детей // Медицинская газета. 2000. № 7.
  4. Леонтьев А.Ф., Шелкович В.И. Генез внепеченочной портальной гипертензии у детей // Детская хирургия. 2005. № 4. С. 39-42.
  5. Мишина Т.П., Разумовский А.Ю., Рачков В.Е., Ситникова М.И. Центральная гемодинамика у детей, оперированных по поводу внепеченочной портальной гипертензии // Хирургия. 2002. № 1. С. 40-45.
  6. Разумовский А.Ю., Рачков В.Е., Феоктистова Е.В., Парамонова С.В., Галибин И.Е. Портальная гипертензия у детей - современные возможности порто-системного шунтирования // Хирургия. 2007. № 9. С. 41-45.
  7. Botha J.F., Campos B.D., Grant W.J. et al. Portosystemic shunts in children: a 15-year experience // J. Am. Coll. Surg. 2004. Vol. 199. No. 2. P. 179-185.
  8. De Ville de Goyet J., Alberti D., Clapuyt P. et al. Direct bypassing of extrahepatic portal venous obstruction in children: a new technique for combined hepatic portal revascularization and treatment of extrahepatic portal hypertension // J. Pediatr. Surg. 1998. Vol. 33. No. 4. P. 597-601.
  9. Gehrke I., John P., Blundell J., Pearson L. et al. Meso-portal bypass in children with portal vein thrombosis: rapid increase of the intrahepatic portal venous flow after direct portal hepatic reperfusion // J. Pediatr. Surg. 2003. Vol. 38. No. 8. P. 1137-1140.
  10. Superina R., Bambini D. A., Lokar J., Rigsby C., Whitington P. F. Correction of extrahepatic portal vein thrombosis by the mesenteric to left portal vein bypass // Ann. Surg. 2006. Vol. 243. No. 4. P. 515-521.

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