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  • 7 -10 (60) 2023 — S.R. Margaryan, Z. B. Mitupov — METHOD FOR IMPROVING BLOOD SUPPLY TO THE LIVER IN A CHILD BY RECONSTRUCTION OF PORTOSYSTEMIC SHUNT AND DISSECTION OF THE CELIC TRUNK

7 -10 (60) 2023 — S.R. Margaryan, Z. B. Mitupov — METHOD FOR IMPROVING BLOOD SUPPLY TO THE LIVER IN A CHILD BY RECONSTRUCTION OF PORTOSYSTEMIC SHUNT AND DISSECTION OF THE CELIC TRUNK

METHOD FOR IMPROVING BLOOD SUPPLY TO THE LIVER IN A CHILD BY RECONSTRUCTION OF PORTOSYSTEMIC SHUNT AND DISSECTION OF THE CELIC TRUNK

S.R. Margaryan, Federal State Autonomous Educational Institution of Higher Education “Russian National Research Medical University named after. N.I. Pirogov” Ministry of Health of Russia, GBUZ “Children’s City Clinical Hospital named after. N.F. Filatova Department of Health, Department of Thoracic Surgery

Z. B. Mitupov, Federal State Autonomous Educational Institution of Higher Education “Russian National Research Medical University named after. N.I. Pirogov” Ministry of Health of Russia, GBUZ “Children’s City Clinical Hospital named after. N.F. Filatova Department of Health, Department of Thoracic Surgery

Rachkov V.E., Federal State Autonomous Educational Institution of Higher Education “Russian National Research Medical University named after. N.I. Pirogov” Ministry of Health of Russia

A. Yu. Razumovsky, Federal State Autonomous Educational Institution of Higher Education “Russian National Research Medical University named after. N.I. Pirogov” Ministry of Health of Russia, GBUZ “Children’s City Clinical Hospital named after. N.F. Filatova Department of Health, Department of Thoracic Surgery

F. V. Shkurov, Federal State Autonomous Educational Institution of Higher Education “First Moscow State Medical University named after. I.M. Sechenov” Ministry of Health of Russia

A. S. Dudinova Federal State Autonomous Educational Institution of Higher Education “Russian National Research Medical University named after. N.I. Pirogov” Ministry of Health of Russia

Resume

 Side-to-side splenorenal anastomosis is the most commonly performed procedure in children with portal hypertension (PH). However, due to a decrease in portal perfusion of the liver, there is a risk of developing liver failure and hepatic encephalopathy, that is, it refers to total portosystemic shunts. In the Children’s City Clinical Hospital named after. N. F. Filatova (Moscow) proposed a new operation – reconstruction of the splenorenal anastomosis (SRA) into a distal splenorenal anastomosis (DSRA) (selective shunt that improves and maintains liver perfusion) by clipping/ligating the splenic vein and its branches. We described a clinical observation of a teenager with hepatic hepatitis, who had previously undergone SRA, and was also diagnosed with concomitant compression stenosis of the celiac trunk (CSCS) (the vessel from which the common hepatic artery arises). That is, the child had a decrease in both venous perfusion of the liver (due to SRA) and arterial perfusion (due to KSChS). The patient underwent simultaneous reconstruction of the SRA into DSRA and dissection of the celiac trunk with subsequent improvement of both venous and arterial blood supply to the liver.

Key words: children; portal hypertension; portosystemic shunts; compression stenosis of the celiac trunk; shunt reconstruction; ligation of the splenic vein; dissection of the celiac trunk; liver perfusion; hyperammonemia.

First page

41

Last page

48

For citation: S.R. Margaryan, Z. B. Mitupov, Rachkov V.E., A. Yu. Razumovsky, F. V. Shkurov, A. S. Dudinova – METHOD FOR IMPROVING BLOOD SUPPLY TO THE LIVER IN A CHILD BY RECONSTRUCTION OF PORTOSYSTEMIC SHUNT AND DISSECTION OF THE CELIC TRUNK //New Day in Medicine 2023 10(60): 41-48 https://newdaymedicine.com/index.php/2023/10/05/l-395/

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