Nii, Akira Department of Pediatric Surgery and Pediatric Endoscopic Surgery, Tokushima University Hospital
Takehara, Hiro-o Department of Pediatric Surgery and Pediatric Endoscopic Surgery, Tokushima University Hospital
Kuyama, Hisako Department of Pediatric Surgery and Pediatric Endoscopic Surgery, Tokushima University Hospital
Shimada, Mitsuo Department of Digestive Surgery and Transplantation, Institute of Health Biosciences, the University of Tokushima Graduate School Tokushima University Educator and Researcher Directory KAKEN Search Researchers
congenital extrahepatic portosystemic shunt
Purpose : A congenital extrahepatic portosystemic shunt (CEPS) is a rare abnormality. The shunts are classified into 2 types. Of these, a type 2-shunt is a side-to-side one, which may be treated by a simple shunt division. The aim of this retrospective study was to clarify the effects of a surgical shunt division on 4 children with type 2-CEPS. Patients : Between June 2002 and June 2008, 4 children with type 2-CEPS underwent a surgical shunt division. Various clinical factors of each patient, including shunt types, shut ratios evaluated by portal scintigraphy using 123I-iodoamphetamine, serum levels of ammonia and total bile acids before and after surgery were evaluated. Findings : Two children had a conventional open surgery and the other two had a laparoscopic surgery. The serum levels of ammonia as well as total bile acids of these children decreased significantly to the normal levels within a month after the surgical shunt divisions. All the children had a better clinical course. Conclusions : A shunt division, especially by laparoscopic surgery, is an effective therapy for type 2-CEPS. To the best of our knowledge by reviewing literatures, our cases are the youngest ones treated by laparoscopic shunt division.
The journal of medical investigation : JMI
jmi_56_1-2_49.pdf 770 KB