Brief Article
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World J Gastroenterol. Oct 14, 2011; 17(38): 4334-4338
Published online Oct 14, 2011. doi: 10.3748/wjg.v17.i38.4334
Sixty-four-slice computed tomography in surgical strategy of portal vein cavernous transformation
Ming-Man Zhang, Cong-Lun Pu, Ying-Cun Li, Chun-Bao Guo
Ming-Man Zhang, Cong-Lun Pu, Ying-Cun Li, Chun-Bao Guo, Department of Hepatobiliary Surgery, Children’s hospital, Chongqing Medical University, Chongqing 400014, China
Author contributions: Guo CB designed the research; Pu CL, Zhang MM, Li YC and Guo CB performed the research; Pu CL and Guo CB analyzed the data and were involved in editing the manuscript; Zhang MM and Pu CL contribute equally to this research; and Guo CB wrote the paper, co-ordinated and provided the collection of all the human material as well as provided financial support for this work.
Supported by National Natural Science Foundation of China, No. 30973440 and No. 30770950; and key project of Chongqing Natural Science Foundation (CSTC, 2008BA0021)
Correspondence to: Chun-Bao Guo, MD, PhD, Department of Hepatobiliary Surgery, Children’s Hospital of Chongqing Medical University, 136 Zhongshan 2nd Rd, Chongqing 400014, China. gchunbao@yahoo.com.cn
Telephone: +86-23-63893006 Fax: +86-23-63893006
Received: August 13, 2010
Revised: November 23, 2010
Accepted: November 30, 2010
Published online: October 14, 2011
Abstract

AIM: To investigate the role of 64-slice computed tomography (CT) in portal vein cavernous transformation to determine surgical strategy.

METHODS: The site of lesions and extent of collateral circulation in 12 pediatric cases of cavernous transformation of the portal vein with surgical treatment were analyzed.

RESULTS: Eleven of 12 children had esophageal varices and were treated with lower esophageal and gastric devascularization and splenectomy, and the other case was only treated with splenectomy. There were eight cases with spontaneous spleen/stomach-renal shunt, four with Retzius vein opening, which was reserved during surgery. Three cases of lesions involving the intrahepatic portal vein (PV) were treated with living donor liver transplantation. One patient died from PV thrombosis after liver transplantation, and the rest had no significant complications.

CONCLUSION: The PV, its branches and collateral circulation were clearly seen by 64-slice spiral CT angiography, which helped with preoperative surgical planning.

Keywords: Cavernous transformation, Portal vein, 64-slice computed tomography, Liver transplantation, Portal hypertension, Esophageal devascularization, Gastric devascularization