Laparoscopic Partial Closure for Congenital Portosystemic Shunt-Indications, Postoperative Management, and Subsequent Complete Closure

Teizaburo Mori, Yohei Yamada, Kiyotomo Abe, Nobuhiro Takahashi, Motohiro Kano, Takumi Fujimura, Toshihiko Watanabe, Seishi Nakatsuka, Ken Hoshino, Tatsuo Kuroda

研究成果: Article査読

3 被引用数 (Scopus)

抄録

Extrahepatic congenital portosystemic shunts (CPSSs) can be occluded by surgical or endovascular approaches. However, when the estimated portal vein (PV) pressure after the closure is high enough to induce symptoms associated with portal hypertension, partial closure is recommended to avoid life-threatening events. In this study, we attempted laparoscopic partial closure of a CPSS in two patients. Along with intraoperative real-time measuring of the PV pressure and angiography, laparoscopic partial closure was performed to achieve a PV pressure of ≤25 mmHg. Subsequently, the intrahepatic portal system grew in both patients. The partially ligated CPSS closed spontaneously in the first patient. In the second patient, laparoscopic complete closure was performed for the residual CPSS 6 months after the first operation. To our knowledge, this is the first report of laparoscopic partial closure for CPSS. Minimally invasive laparoscopic partial ligation of CPSS is technically feasible and useful when the estimated PV pressure is too high to tolerate one-step complete closure.

本文言語English
ページ(範囲)573-578
ページ数6
ジャーナルJournal of Laparoendoscopic and Advanced Surgical Techniques
29
4
DOI
出版ステータスPublished - 2019 4月 1

ASJC Scopus subject areas

  • 外科

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