Side-to-Side Portacaval Shunt in the Treatment of Budd-Chiari Syndrome

Hepatic vein thrombosis and PVT: A personal view on the contemporary development of ideas

“…The idea of relieving hepatic congestion due to outflow tract obstruction by turning the PV from an inflow tract into an outflow tract through a side-to-side portosystemic shunt (or its hemodynamic equivalents of proximal splenorenal or mesocaval shunts) dates back to 1948 [151] but was really only developed in the early 1970s. [152,153] In those days, surgical shunts had been widely used to treat cirrhotic portal hypertension owing to excellent success at relieving ascites and gastrointestinal bleeding. The results of subsequent randomized controlled trials did not show significant improvements in survival but documented an increased risk of encephalopathy.…”

Ultrasound Evaluation of the Hepato–Portal System

“…Approximately 20% of patients may demonstrate portal vein as well as hepatic vein thrombosis. [11][12][13]…”

Liver Transplantation

“…17 However, the authors would currently first consider the use of portocaval shunting procedures in patients without inferior vena caval occlusion. 15,16 The ability to stop acute exsanguinating variceal bleeding by the combined use of a Sengstaken-Blakemore tube and peresophageal injection sclerotherapy 35 might well result in more cirrhotic patients surviving long enough to be candidates for liver transplantation. Furthermore, the eradication of esophageal varices and prevention of rebleeding using the simple technique of repeated peresophageal injection sclerotherapy 36 should also increase the potential pool of cirrhotic recipients.…”