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The usefulness of distal splenorenal shunt in children with portal hypertension for the treatment of severe thrombocytopenia and leukopenia

Cited 10 time in Web of Science Cited 11 time in Scopus
Authors
Moon, Suk-Bae; Jung, Sung-Eun; Ha, Jong-Won; Park, Kwi-Won; Seo, Jeong-Kee; Kim, Woo-Ki
Issue Date
2008-01-16
Publisher
Springer Verlag
Citation
World J Surg. 2008 ;32(3):483-7.
Keywords
AdolescentChildChild, PreschoolFemaleFollow-Up StudiesHumansHypertension, Portal/etiology/*surgeryLeukocyte Count/statistics & numerical dataLeukopenia/*surgeryLongitudinal StudiesMalePlatelet Count/statistics & numerical dataSplenorenal Shunt, Surgical/*methodsStatistics, NonparametricThrombocytopenia/*surgeryTreatment Outcome
Abstract
BACKGROUND: In the current era of transplantation and therapeutic endoscopy, the role of the distal splenorenal shunt (DSRS) for portal hypertension (PH) has diminished. We reviewed the outcome of the use of DSRS in children to determine the usefulness of this operation. METHODS: In the follow-up course for PH from 1987 to 2006, 15 patients who developed severe thrombocytopenia (platelet count <50 x 10(3)/mm(3)) and/or leukopenia (WBC count <3000/mm(3)) with normal liver function were referred for DSRS. Primary diagnosis was portal vein thrombosis (N=10) and congenital hepatic fibrosis (N=5). Platelet, WBC count, liver function test, and spleen size were checked before and after DSRS. Shunt patency was accessed postoperatively. Operative morbidity, mortality, and long-term outcomes were measured. RESULTS: Platelet count and WBC count increased in individual patients. Mean value of each count increased significantly after DSRS (p=0.002, .004, respectively). Spleen size decreased significantly (N=7, p=0.018). Shunt patency rate was 100%. There was one postoperative complication and no postoperative mortality. Two patients developed portopulmonary hypertension. No patients underwent subsequent transplantation or endoscopic treatment for gastroesophageal varices after DSRS. CONCLUSIONS: DSRS is an effective and reliable procedure for children with PH and is still useful for selected pediatric patients.
ISSN
0364-2313 (Print)
Language
English
URI
http://hdl.handle.net/10371/62842
DOI
https://doi.org/10.1007/s00268-007-9356-0
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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