"U-shaped" mesoportal jump graft to manage portal vein thrombosis during liver transplantation: A case report.
Case report
Iliac bifurcation
Jump graft
Portal vein thrombosis
Yerdel classification
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
2020
2020
Historique:
received:
19
02
2020
revised:
09
04
2020
accepted:
28
04
2020
pubmed:
23
5
2020
medline:
23
5
2020
entrez:
23
5
2020
Statut:
ppublish
Résumé
Once considered a contraindication to liver transplantation, portal vein thrombosis still represents a significant challenge to the liver transplant surgeon. Yerdel grade 3 thrombosis is usually managed by interposing a donor iliac vein jump graft between graft portal vein and distal superior mesenteric vein. Venous patch is normally placed in a retrogastric position to avoid its kinking. We report a new technical variant of standard mesoportal jump graft, in which a U-shaped graft was obtained using iliac bifurcation. This technique was used to manage a case of grade 3 portal vein thrombosis in which portal vein was unsuitable due to severe pylephlebitis and pylorus dissection had to be abandoned due to inflammatory changes issue of chronic pancreatitis. The venous patch was of sufficient length and shape to bypass pancreatic head and first duodenum, avoiding the need for its retrogastric placement and pylorus dissection. This case is a further demonstration that technical approach to portal vein thrombosis must be tailored according to its extent and surgical scenario. In selected cases, use of a curved U-shaped jump graft may represent a valuable option. This technical option should be included among options for the management of portal vein thrombosis and be part of the armamentarium of liver transplant surgeon.
Identifiants
pubmed: 32442917
pii: S2210-2612(20)30293-5
doi: 10.1016/j.ijscr.2020.04.098
pmc: PMC7240169
pii:
doi:
Types de publication
Case Reports
Langues
eng
Pagination
73-77Informations de copyright
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Authors declare they have no conflict of interest.
Références
Ann Surg. 1991 Mar;213(3):199-206
pubmed: 1998400
Int J Surg. 2018 Dec;60:132-136
pubmed: 30342279
Am J Transplant. 2007 Feb;7(2):454-60
pubmed: 17229075
Transplantation. 2012 Dec 15;94(11):1145-53
pubmed: 23128996
J Hepatol. 2019 Nov;71(5):1038-1050
pubmed: 31442476
Liver Transpl. 2015 Jul;21(7):944-52
pubmed: 25891227
J Hepatobiliary Pancreat Sci. 2015 Jun;22(6):467-74
pubmed: 25755116
Transpl Int. 1997;10(2):125-32
pubmed: 9089998
Transplantation. 2015 Nov;99(11):2347-55
pubmed: 25905983
J Hepatol. 2016 Jan;64(1):179-202
pubmed: 26516032
Transplantation. 2000 May 15;69(9):1873-81
pubmed: 10830225