Experience in diagnosis and treatment of intercurrent cavernous transformation of the portal vein after surgery for congenital choledochal cyst in children and literature review
LIAO Siqi
YIN Qiang
PENG Yuming
JI Chunyi
CHEN Lijian
XIE Weixin
Abstract：Objective To discuss the experience in diagnosis and treatment of intercurrent cavernous transformation of the portal vein(CTPV)after surgery for congenital choledochal cyst(CCC)in children combining literature review.Methods The clinical data and postoperative follow-up results of 2 children with intercurrent CTPV after surgery for CCC who were admitted to Hunan Children's Hospital were retrospectively analyzed,and the relevant literature was summarized and analyzed.Results Case 1:female,6 years and 9 months old,undergoing radical surgery for CCC in another hospital more than 4 years ago.Case 2:female,11 years and 7 months old,undergoing radical surgery for CCC in another hospital more than 10 years ago.The two children were diagnosed with CTPV following an emergency admission due to gastrointestinal bleeding.Intraoperative angiography indicated occlusion of the main portal vein in the two children,and the"main protal vein-left portal vein shunt(MPV-LPV)"was performed on them.The portal vein pressure after the operation decreased to the normal range in the two children.The two children were followed up for one year after the operation.The bypass vessels were unobstructed and there were no complications such as gastrointestinal bleeding in them.A total of 8 patients with intercurrent CTPV after surgery for CCC were included in combination with literature review.Among them,2 patients received MPV-LPV,3 patients received left gastric vein-left portal vein bypass(LGV-LPV)procedure,2 patients received Roux-Y jejunal vein-left portal vein bypass(RYV-LPV)procedure,and 1 patient received percutaneous transhepatic angioplasty.After postoperative follow-up,7 patients had unobstructed shunt vessels,and 1 patient had shunt vessel occlusion.Conclusion CTPV is a rare complication after surgery for CCC.During the radical surgery for CCC,attention should be paid to protecting the portal vein to reduce the risk of injury.Once symptoms such as gastrointestinal bleeding and hypersplenism occur,it is recommended to choose Rex shunt as the first option to restore the blood flow from the portal vein to the liver.
Keywords：ChildrenCongenital choledochal cyst(CCC)Cavernous transformation of the portal vein(CTPV)Rex shuntPostoperative complications
Publication Date：2025-06-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 632-636 )