Portal vein thrombosis surgery

Portal vein thrombosis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Surgical intervention is not recommended for the management of [disease name].

OR

Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]

OR

The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].

OR

The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

Surgery is the mainstay of treatment for [disease or malignancy].

Indications

• Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
  • [Indication 1]
  • [Indication 2]
  • [Indication 3]

Surgery

• Surgery procedures of portal vein thrombosis include:
  • 1. Shunt surgery
    • The preferred surgical shunt is usually distal splenorenal shunt. Splenectomy and other shunt procedures have been performed for patients with splenic vein thrombosis and whom surgery is udertaken.
    • In pateinets with portal vein thrombosis indications for shunt surgery include:
      • Failed endotherapy
      • Symptomatic portal hypertensive biliopathy
      • Symptomatic hypersplenism
      • Ectopic variceal bleed
      • Severe growth retardation
      • Poor chances of follow up and on demand one time treatment
    • Shunts may be selective or non-selective. The different types of shunt surgery include:
      • Selective shunts
        • Distal lienorenal shunt
        • Mesenteric-left portal vein bypass(Rex shunt)
        • Warren Zeppa distal splenorenal shunts
        • Mesocaval shunts
      • Non-selective shunts
        • Portocaval shunts
        • Proximal lienorenal shunts
        • End to side mesocaval and large diameter interposition portocaval shunts
        • Mesocaval shunts