Rex shunt for extrahepatic portal hypertension in children with extrahepatic portal vein obstruction.

Abstract

Objective To review the efficacy and safety of Rex shunts for patients with extrahepatic portal vein obstruction (EHPVO). Methods Ten children with extra-hepatic portal vein obstruction (EHPVO) operated between October 2008 and February 2010 were reviewed. There were 8boys and 2 girls. Their ages ranged from 19 to 144 months. Seven of the patients suffered from recurrence upper gastro-intestinal (GI) bleeding, and 3 from splenomegaly and hypersplenism. Upper GI radiography (UGIR) demonstrated esophageal and gastric varices (EGV). Ultrasonograph (US) also showed EHPVO. All patients underwent mesenteric-to-left portal vein bypass (MLPVB). Patients were followed up 4-20 (average: 9. 6 ±5.0 ) months. Results The mean duration of operation was 220 ± 14. 7 minutes (range: 200 to 240) without intraoperative complication. Operative blood loss was 10 to 50 ml with no need for blood transfusion. Portal pressure decreased after Rex shunt. The postoperative course was uneventful in 10 patients with hospital stay ranging from 8 to 15days. There was no further gastrointestinal bleeding. The spleen size dccreased,The platelet counts and white blood cell counts increased, and there was no postoperative complication during the followed-up period. Conclusions Rex shunt for patients with EHPVO is feasible, safe and effective. Key words: Portal vein; Portalcaval shunt, surgical; Child