Portal vein thrombosis surgery: Difference between revisions
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*****End to side mesocaval and large diameter interposition portocaval shunts | *****End to side mesocaval and large diameter interposition portocaval shunts | ||
*****Mesocaval shunts | *****Mesocaval shunts | ||
**'''2. Transjugular intrahepatic portosystemic shunting''' | |||
* [[Transjugular intrahepatic portosystemic shunt|Transjugular intrahepatic portosystemic shunting (TIPS)]] is bypassing the high flow rate of [[portal vein]] into the [[Systemic vein|systemic veins]]. | |||
* [[TIPS]] would decrease the pressure over the [[portal system]] and a decreased risk of complications, such as:<ref name="pmid291109902">{{cite journal |vauthors=Lahat E, Lim C, Bhangui P, Fuentes L, Osseis M, Moussallem T, Salloum C, Azoulay D |title=Transjugular intrahepatic portosystemic shunt as a bridge to non-hepatic surgery in cirrhotic patients with severe portal hypertension: a systematic review |journal=HPB (Oxford) |volume= |issue= |pages= |year=2017 |pmid=29110990 |doi=10.1016/j.hpb.2017.09.006 |url=}}</ref> | |||
** [[Splenomegaly]] | |||
** [[Esophageal varices]] | |||
** [[Gastric varices]] | |||
** [[Collateral circulation|Collateral formations]] | |||
<br> | |||
==References== | ==References== | ||
Revision as of 20:01, 8 December 2017
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Portal vein thrombosis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Portal vein thrombosis surgery On the Web |
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American Roentgen Ray Society Images of Portal vein thrombosis surgery |
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Risk calculators and risk factors for Portal vein thrombosis surgery |
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
- Selective shunts
- 1. Shunt surgery
- 2. Transjugular intrahepatic portosystemic shunting
- Transjugular intrahepatic portosystemic shunting (TIPS) is bypassing the high flow rate of portal vein into the systemic veins.
- TIPS would decrease the pressure over the portal system and a decreased risk of complications, such as:[1]
References
- ↑ Lahat E, Lim C, Bhangui P, Fuentes L, Osseis M, Moussallem T, Salloum C, Azoulay D (2017). "Transjugular intrahepatic portosystemic shunt as a bridge to non-hepatic surgery in cirrhotic patients with severe portal hypertension: a systematic review". HPB (Oxford). doi:10.1016/j.hpb.2017.09.006. PMID 29110990.