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World Journal of Surgery

, Volume 32, Issue 3, pp 483–487 | Cite as

The Usefulness of Distal Splenorenal Shunt in Children with Portal Hypertension for the Treatment of Severe Thrombocytopenia and Leukopenia

  • Suk-Bae Moon
  • Sung-Eun Jung
  • Jong-Won Ha
  • Kwi-Won Park
  • Jeong-Kee Seo
  • Woo-Ki Kim
Article

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 × 103/mm3) and/or leukopenia (WBC count < 3000/mm3) 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.

Keywords

White Blood Cell Count Portal Hypertension Portal Vein Thrombosis Severe Thrombocytopenia Hypersplenism 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2007

Authors and Affiliations

  • Suk-Bae Moon
    • 1
  • Sung-Eun Jung
    • 1
  • Jong-Won Ha
    • 1
  • Kwi-Won Park
    • 1
  • Jeong-Kee Seo
    • 1
  • Woo-Ki Kim
    • 1
  1. 1.Department of Pediatric SurgerySeoul National University Children’s HospitalSeoulKorea

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