Use of Pericholedochal Plexus for Portal Flow Reconstruction in Diffuse Portal Vein Thrombosis: Case Report

Lee, S.; Kim, D.J.; Kim, I.-G.; Jeon, Jang Yong; Jung, Jinhong; Choi, Gwangyoon; Kim, J.S.

doi:10.1016/j.transproceed.2014.02.001

Cited by 8 publications

(4 citation statements)

References 5 publications

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“…Eleven cases (1986-2017) of pericholedochal varix to portal vein anastomosis have been reported in patients with complex PVT 46,[79][80][81][82][83][84] ( Table 3). Postoperative mortality was nil and postoperative morbidity could not be clarified.…”

Section: Large Pericholedochal Varix To Portal Vein Anastomosismentioning

confidence: 99%

Novel classification of non-malignant portal vein thrombosis: A guide to surgical decision-making during liver transplantation

Bhangui

Lim

Levesque

et al. 2019

Journal of Hepatology

130

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Non-tumoral portal vein thrombosis (PVT) is present at liver transplantation in 5% to 26% of cirrhotic patients, and the prevalence of complex PVT as defined here (grade 4 Yerdel, and grade 3,4 Jamieson and Charco) has been reported in 0% to 2.2%. Adequate portal inflow is mandatory to ensure graft and patient survival after liver transplantation. With time, the proposed classifications of non-tumoral chronic PVT have evolved from being anatomy-based, to also incorporating functional parameters. However, none of the currently proposed classifications are directed towards decision-making, regarding the choice of inflow to the graft during transplantation and the outcomes thereof. The present scoping review i) addresses the limits of the currently available classifications in terms of surgical decisiveness, ii) clarifies the concept of physiological or non-physiological portal inflow reconstruction, and subsequently, iii) proposes a new classification of non-tumoral PVT in candidates for liver transplantation; to help tailor the surgical strategy to an individual patient, in order to provide portal inflow to the graft together with control of prehepatic portal hypertension whenever feasible.

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Section: Large Pericholedochal Varix To Portal Vein Anastomosismentioning

confidence: 99%

Novel classification of non-malignant portal vein thrombosis: A guide to surgical decision-making during liver transplantation

Bhangui

Lim

Levesque

et al. 2019

Journal of Hepatology

130

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“…Lee et al reported in 2014 the case of a patient with grade 4 PVT successfully treated with the use of pericholedochal plexus for portal inflow restoration [ 8 ]. In detail, they performed a direct anastomosis to the donor's PV with interrupted sutures using 5-0 Prolene sutures.…”

Section: Resultsmentioning

confidence: 99%

Extra-Anatomic Jump Graft from the Right Colic Vein: A Novel Technique to Manage Portal Vein Thrombosis in Liver Transplantation

Magistri

Tarantino

Olivieri

et al. 2018

Case Reports in Surgery

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Background In the context of cirrhosis, portal vein thrombosis (PVT) is present in 2.1% to 26% of patients. PVT is no longer considered an absolute contraindication for liver transplantation, and nowadays, surgical strategies depend on the extent of PVT. Complete PVT is associated with higher morbidity rates and poor prognosis, while comparable long-term outcomes can be achieved as long as physiological portal inflow is restored. Materials and Methods We report our experience with a 45-year-old patient undergoing liver transplant with a PVT (stage III-b). To restore portal vein inflow to the liver, an extra-anatomic jump graft from the right colic vein with donor iliac vein interposition was constructed. Results The patient recovered well, with a progressive improvement of the general conditions, and was finally discharged on p.o.d. 14. No anastomotic defects were found at the postoperative CT scan 10 months after the surgery. Conclusion Our technical innovation represents a valid and safe alternative to the cavoportal hemitransposition, providing a proper flow restoration and reproducing a physiological setting, while avoiding the complications related to the cavoportal shunt. We believe that the reconstitution of liver portal inflow should be obtained with the most physiological approach possible and considering long-term liver function.

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“…The portal vein-variceal anastomosis is a challenging physiological non-anatomical technique of portal vein inflow reconstruction used and described rarely. In those procedures, enlarged splanchnic varices[ 31 - 34 ], LGV[ 35 - 38 ], or pericholedochal varix[ 39 , 40 ] is used. Use of a splanchnic varix such as a dilated LGV necessitates a meticulous and very careful dissection in a hostile surrounding of other dilated fragile varices.…”

Section: Discussionmentioning

confidence: 99%

Portal vein-variceal anastomosis for portal vein inflow reconstruction in orthotopic liver transplantation: A case report and review of literature

Gravetz¹

2022

WJT

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BACKGROUND Portal vein thrombosis (PVT) is a frequent complication occurring in 5% to 26% of cirrhotic patients candidates for liver transplantation (LT). In cases of extensive portal and or mesenteric vein thrombosis, complex vascular reconstruction of the portal inflow may become necessary for a successful orthotopic LT (OLT). CASE SUMMARY A 54-year-old male with history of cirrhosis secondary to schistosomiasis complicated with extensive portal and mesenteric vein thrombosis and severe portal hypertension who underwent OLT with portal vein-left gastric vein anastomosis. CONCLUSION We review the various types of PVT, the portal venous inflow reconstruction techniques.

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Use of Pericholedochal Plexus for Portal Flow Reconstruction in Diffuse Portal Vein Thrombosis: Case Report

Cited by 8 publications

References 5 publications

Novel classification of non-malignant portal vein thrombosis: A guide to surgical decision-making during liver transplantation

Novel classification of non-malignant portal vein thrombosis: A guide to surgical decision-making during liver transplantation

Extra-Anatomic Jump Graft from the Right Colic Vein: A Novel Technique to Manage Portal Vein Thrombosis in Liver Transplantation

Portal vein-variceal anastomosis for portal vein inflow reconstruction in orthotopic liver transplantation: A case report and review of literature

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