ArticlePediatric surgery international2023
Surgical management of extrahepatic portal vein obstruction in children: advantages of MesoRex shunt compared with distal splenorenal shunt.
Article in Pediatric surgery international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Analysis of portal vein thrombosis prevalence and risk factors in neonates following umbilical venous catheterization: a systematic review and meta-analysis.Jornal de pediatriaPooled it
- Key factors for predicting outcomes one year after Meso-Rex bypass surgery and optimizing the surgical plan in children with extrahepatic portal vein obstruction.European radiology · 2026Article
- Predictive value of early postoperative hemodynamic parameters of Rex shunt graft for graft thrombosis in children with cavernous transformation of the portal vein.Pediatric surgery international · 2026Article
- Shunt Surgery for Pediatric Prehepatic Portal Hypertension: A Single-Center Case Series.Journal of clinical medicine · 2025Article
- Surgical outcome of extrahepatic portal venous obstruction: Audit from a tertiary referral centre in Eastern India.Annals of hepato-biliary-pancreatic surgery · 2023Article
- Ectopic Variceal Bleeding from the Hepaticojejunostomy due to Extrahepatic Portal Vein Occlusion: How to Treat?Vascular specialist international · 2023Review
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo review surgical management of extrahepatic portal vein obstruction (EHPVO) at Red Cross War Memorial Children's Hospital and compare MesoRex shunt (MRS) with distal splenorenal shunt (DSRS).
methodsThis is a single-centre retrospective review documenting pre- and post-operative data in 21 children. Twenty-two shunts were performed, 15 MRS and 7 DSRS, over an 18-year period. Patients were followed up for a mean of 11 years (range 2-18). Data analysis included demographics, albumin, prothrombin time (PT), partial thromboplastin time (PTT), International normalised ratio (INR), fibrinogen, total bilirubin, liver enzymes and platelets before the operation and 2 years after shunt surgery.
resultsOne MRS thrombosed immediately post-surgery and the child was salvaged with DSRS. Variceal bleeding was controlled in both groups. Significant improvements were seen amongst MRS cohort in serum albumin, PT, PTT, and platelets and there was a mild improvement in serum fibrinogen. The DSRS cohort showed only a significant improvement in the platelet count. Neonatal umbilic vein catheterization (UVC) was a major risk for Rex vein obliteration.
conclusionIn EHPVO, MRS is superior to DSRS and improves liver synthetic function. DSRS does control variceal bleeding but should only be considered when MRS is not technically feasible or as a salvage procedure when MRS fails.
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