PARTIAL PORTOSYSTEMIC SHUNTING BY CARBON-COATED ePTFE GRAFTS FOR PORTAL HYPERTENSION IN CIRRHOTIC PATIENTS
https://doi.org/10.15825/1995-1191-2010-2-48-53
Abstract
We present our first experience gained in use of polytetrafluoroethylene carbon-coated grafts for partial portosystemic shunting in three cirrhotic patients. The results obtained indicate that these grafts in mesocaval position can function as a long-term «bridge» to hepatic transplantation in patients with uncontrolled gastroesophageal varices. The different options of portal hypertension treatment and the current role of shunting procedures in the era of liver transplantation are discussed in short literature review.
About the Authors
I. A. PorshennikovRussian Federation
A. V. Marchenko
Russian Federation
I. N. Kim
Russian Federation
A. Yu. Bykov
Russian Federation
E. V. Grigorov
Russian Federation
References
1. Adam R., Diamond T., Bismuth H. Partial porta-caval shunt: renaissance of an old concept // Surgery. 1991. Vol. 111. P. 610–616.
2. Bacourt F. Prospective randomized study of carbon-im- pregnated polytetrafluoroethylene grafts for below-knee popliteal and distal bypass: results at 2 years // Ann. Vasc. Surg. 1997. Vol. 11. P. 596–603.
3. Batignani G., Vizzutti F., Rega L. et al. Small diameter H-graft porta-caval shunt performed at different stages of liver disease // Hepatobiliary Pancreat. Dis. Int. 2004. Vol. 3. P. 516–521.
4. Belghiti J., Grenier P., Nouel O. et al. Long-term loss of Warren’s shunt selectivity. Angiographic demonstra- tion // Arch Surg. 1981. Vol. 116. P. 1121–1124.
5. Bismuth H., Moreaux J., Hepp J. L’anastomose spléno- rénale centrale dans le traitement de l’hypertension por- tale // Ann. Chir. 1966. Vol. 20. P. 1441–1445.
6. Bosch J., Abraldes J.G., Groszmann R. Current manage- ment of portal hypertension // J. Hepatol. 2003. Vol. 38. P. S54–S68.
7. Castaing D., Adam R., Azoulay D. Chirurgie du foie et de l’hypertension portale. Paris: Masson, 2006.
8. Hillebrand D.J., Kojouri K., Cao S. et al. Small-diameter portacaval H-graft shunt: a paradigm shift back to surgi- cal shunting in the management of variceal bleeding in
9. patients with preserved liver function // Liver Transpl.
10. Vol. 6. P. 459–465.
11. Klempnauer J., Schrem H. Review: surgical shunts
12. and encephalopathy // Metab. Brain Dis. 2001. Vol. 16.
13. P. 21–25.
14. Paquet K.J. Prophylactic endoscopic sclerosing treat-
15. ment of the esophageal wall in varices – a prospective controlled randomized trial // Endoscopy. 1982. Vol. 14. P. 4–5.
16. Rosemurgy A.S., Serafini F.M., Zweibel B.R. et al. Trans- jugular intrahepatic portosystemic shunt vs. small-dia- meter prosthetic H-graft portacaval shunt: extended fol- low-up of an expanded randomized prospective trial // J. Gastrointest. Surg. 2000. Vol. 4. P. 589–597.
17. Rosemurgy A.S., Bloomston M., Clark W.C. et al. H-graft portacaval shunts versus TIPS: ten-year follow-up of a randomized trial with comparison to predicted survi- vals // Ann. Surg. 2005. Vol. 241. P. 238–246.
18. Sarfeh I.J., Rypins E.B., Mason G.R. A systematic app- raisal of portacaval H-graft diameters. Clinical and he- modynamic perspectives // Ann. Surg. 1986. Vol. 204. P. 356–363.
19. Vorobioff J., Groszmann R.J., Picabea E. et al. Prognostic value of hepatic venous pressure gradient measurements in alcoholic cirrhosis: a 10-year prospective study // Gas- troenterology. 1996. Vol. 111. P. 701–709.
Review
For citations:
Porshennikov I.A., Marchenko A.V., Kim I.N., Bykov A.Yu., Grigorov E.V. PARTIAL PORTOSYSTEMIC SHUNTING BY CARBON-COATED ePTFE GRAFTS FOR PORTAL HYPERTENSION IN CIRRHOTIC PATIENTS. Russian Journal of Transplantology and Artificial Organs. 2010;12(2):48-53. (In Russ.) https://doi.org/10.15825/1995-1191-2010-2-48-53