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Temporary portal decompression during liver transplantation: a video review of the different techniques

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Abstract

Purpose

Temporary portal decompression (TPD) during liver transplantation (LT) remains a divisive technical issue in the liver transplant community. In this video-based article, we show the technical details of the different techniques used for TPD during LT.

Methods

An early portal section, before liver mobilization, should be preferred in order to achieve hepatectomy of a totally devascularized liver. Portal decompression can be achieved through direct right portocaval shunts and indirect portosystemic shunts (i.e., mesentericosaphenous and portosaphenous shunts).

Results

The preference for direct portocaval or indirect portosystemic shunts is tailored on patients and anatomical characteristics. Each of these three techniques presents specific indications, limitations, and advantages.

Conclusion

TPD during LT can be achieved through different techniques that aim to facilitate the recipient hepatectomy, reduce the blood loss, and maintain hemodynamic stability.

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Authors and Affiliations

  1. Hepato-Pancreato-Biliary Surgery and Liver transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 67098, Strasbourg, France

    Pietro Addeo, Olivier Julliard, Alfonso Terrone, Caroline Schaaf, François Faitot & Philippe Bachellier

Authors
  1. Pietro Addeo
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  2. Olivier Julliard
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  3. Alfonso Terrone
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  4. Caroline Schaaf
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  5. François Faitot
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  6. Philippe Bachellier
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Contributions

Substantial contributions to the conception or design of the work: PA, OJ, AT, CS, FF, and PB. Acquisition, analysis, or interpretation of data for the work: PA, OJ, AT, CS, FF, and PB. Drafting the work or revising it critically for important intellectual content and final approval of the version to be published: PA, OJ, AT, CS, FF, and PB. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: PA, OJ, AT, CS, FF, and PB

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Correspondence to Pietro Addeo.

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Addeo, P., Julliard, O., Terrone, A. et al. Temporary portal decompression during liver transplantation: a video review of the different techniques. Langenbecks Arch Surg 406, 227–231 (2021). https://doi.org/10.1007/s00423-020-01991-z

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  • DOI: https://doi.org/10.1007/s00423-020-01991-z

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