Current Status of Surgical Therapy for Cavernous Transformation of Portal Vein_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Xinbo , TONG Zhongxun , LIU Wei , LI Li

Liver Transplantation Centre, The First People’s Hospital of Kunming City and The Affiliated Ganmei Hospital of Kunming Medical College, Kunming 650011, China;

Corresponding author：

Keywords：

Cavernous transformation of portal vein; Surgical therapy

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Objective To review the advancement of surgical therapy for cavernous transformation of portal vein. Methods The relevant literatures on therapy for cavernous transformation of portal vein in recent years were collected and reviewed.　Results The main symptoms of the patients are repeated haematemesis and hemafecia, hypersplenotrophy and hypersplenia. Most cases can be detected by ultrasonography or portal venography. Splenectomy and by-pass technique plus disconnection are the preferred operation. Conclusion Therapy for cavernous transformation of portal vein will be further developed.

Citation： WANG Xinbo,TONG Zhongxun,LIU Wei,LI Li. Current Status of Surgical Therapy for Cavernous Transformation of Portal Vein. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(12): 877-879. doi: Copy

1.	蒋小云, 陈述枚. 门静脉海绵样变性的诊疗进展 [J]. 国外医学·儿科学分册, 1999; 26(3)∶128.
2.	冯子毅, 刘磊, 夏培，等. 小儿门静脉海绵样变性的分型及手术方式选择的探讨 [J]. 中国现代医学杂志, 2004; 14（8）∶114.
3.	Karagulle E, Turk E, Gokturk HS, et al. Prothrombin 20210 G/A defect as a cause of mesenteric venous infarction: report of a case [J]. Surg Today, 2007; 37(3)∶251.
4.	Hwang S, Moon KM, Park JI, et al. Retroduodenal resection of ampullary carcinoid tumor in a patient with cavernous transformation of the portal vein [J]. J Gastrointest Surg, 2007; 11(10)∶1322.
5.	Ohnishi K, Okuda K, Ohtsuki T, et al. Formation of hilar collaterals or cavernous transformation after portal vein obstruction by hepatocellular carcinoma. Observations in ten patients [J]. Gastroenterology, 1984; 87(5)∶1150.
6.	Gonen C, Akarsu M, Solmaz D, et al. Hodgkin’s disease presenting with chylous ascites and cavernous transformation of the portal vein [J]. Dig Dis Sci, 2007; 52(12)∶3511.
7.	Lupescu I, Masala N, Capsa R, et al. CT and MRI of acquired portal venous system anomalies [J]. J Gastrointestin Liver Dis, 2006; 15(4)∶393.
8.	方驰华, 项楠, 范应方, 等. 64层螺旋CT三维成像在消化系统疾病诊治中的临床应用价值 [J]. 中华外科杂志, 2007; 45(13)∶909.
9.	齐立行, 杜国元, 陈佛来. 门静脉海绵样变(附2例报告) [J]. 中国实用外科杂志， 1998; 18（8）∶480.
10.	Frutos Bernal MD, Fernández Hernández JA, Carrasco Prats M, et al. Portal-splenic-mesenteric venous thrombosis secondary to a mutation of the prothrombin gene [J]. Gastroenterol Hepatol, 2005; 28(6)∶329.
11.	Miniati DN, Padidar AM, Kee ST, et al. Portal vein thrombosis after laparoscopic splenectomy: an ongoing clinical challenge [J]. JSLS, 2005; 9(3)∶335.
12.	杨镇, 刘飞龙, 戴植本, 等. 贲门周围血管离断术治疗门静脉高压症的疗效分析 [J]. 中华普通外科杂志, 1998; 13(2)∶74.
13.	杨灵, 肖渝清, 陈矢明, 等. 门静脉海绵样变的手术治疗 [J]. 腹部外科, 2003； 16(2)∶118.
14.	Matsumoto H, Suzuki F, Souda K, et al. Improved long-term survival following complete eradication of esophageal varices by sclerotherapy [J]. Hepatogastroenterology, 1999; 46(25)∶172.
15.	曹农, 俞永江, 柴琛, 等. 门静脉高压症外科治疗185例 [J]. 肝胆胰外科杂志, 2008; 20(4)∶286.
16.	Condino AA, Ivy DD, O’Connor JA, et al. Portopulmonary hypertension in pediatric patients [J]. J Pediatr, 2005; 147(1)∶20.
17.	Warren WD, Henderson JM, Millikan WJ, et al. Management of variceal bleeding in patients with noncirrhotic portal vein thrombosis [J]. Ann Surg, 1988; 207(5)∶623.
18.	Bambini DA, Superina R, Almond PS, et al. Experience with the Rex shunt (mesenterico-left portal bypass) in children with extrahepatic portal hypertension [J]. J Pediatr Surg, 2000; 35(1)∶13.
19.	Wax JR, Pinette MG, Cartin A, et al. Cavernous transformation of the portal vein complicating pregnancy [J]. Obstet Gynecol, 2006; 108(3 Pt 2)∶782.
20.	赵龙栓, 范应中, 许培钦. 改良脾肺固定术治疗门静脉海绵样变性 [J]. 中国综合临床, 2003; 19(10)∶950.
21.	肖渝清, 胡先典. 门静脉海绵样变的手术治疗 [J]. 中华肝胆外科杂志, 2003; 9（10）∶625.
22.	Walser EM, Soloway R, Raza SA, et al. Transjugular portosystemic shunt in chronic portal vein occlusion: importance of segmental portal hypertension in cavernous transformation of the portal vein [J]. J Vasc Interv Radiol, 2006; 17(2 Pt 1)∶373.
23.	Senzolo M, Tibbals J, Cholongitas E, et al. Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with and without cavernous transformation [J]. Aliment Pharmacol Ther, 2006; 23(6)∶767.
24.	李德宇. 门静脉海绵样变性的外科诊断与治疗 [J]. 实用儿科临床杂志, 2005; 20(8)∶812.
25.	熊毅敏, 徐维田, 王一鸣，等. 门静脉海绵样变性11例临床分析 [J]. 实用医学杂志, 2005; 21(5)∶484.
26.	宋军民, 田丰, 李岩，等. 门静脉海绵样变性10例临床分析 [J]. 辽宁医学杂志, 2004; 18(2)∶93.
27.	旷历琼. 门静脉海绵样变性7例临床分析 [J]. 现代中西医结合杂志, 2007; 16（34）∶5109.
28.	花荣, 孙勇伟, 吴志勇. 联合手术治疗儿童门静脉海绵样变性肝前性门静脉高压症 [J]. 肝胆外科杂志, 2005; 13（6）∶428.
29.	张明满, 金先庆, 严律南, 等. 亲体肝移植治疗儿童门静脉海绵样变性3例临床分析　[J]. 中华肝脏病杂志, 2008; 16(4)∶270.
30.	Hajdu CH, Murakami T, Diflo T, et al. Intrahepatic portal cavernoma as an indication for liver transplantation [J]. Liver Transpl, 2007; 13(9)∶1312.
31.	Silva MA, Jambulingam PS, Gunson BK, et al. Hepatic artery thrombosis following orthotopic liver transplantation: a 10-year experience from a single centre in the United Kingdom [J]. Liver Transpl, 2006; 12(1)∶146.
32.	Bauer J, Johnson S, Durham J, et al. The role of TIPS for portal vein patency in liver transplant patients with portal vein thrombosis [J]. Liver Transpl, 2006; 12(10)∶1544.
33.	王俊, 蔡威, 潘伟华，等. 肝移植治疗小儿先天性门静脉海绵样变 [J]. 上海交通大学学报(医学版), 2006; 26(6)∶643.

1. 蒋小云, 陈述枚. 门静脉海绵样变性的诊疗进展 [J]. 国外医学·儿科学分册, 1999; 26(3)∶128.
2. 冯子毅, 刘磊, 夏培，等. 小儿门静脉海绵样变性的分型及手术方式选择的探讨 [J]. 中国现代医学杂志, 2004; 14（8）∶114.
3. Karagulle E, Turk E, Gokturk HS, et al. Prothrombin 20210 G/A defect as a cause of mesenteric venous infarction: report of a case [J]. Surg Today, 2007; 37(3)∶251.
4. Hwang S, Moon KM, Park JI, et al. Retroduodenal resection of ampullary carcinoid tumor in a patient with cavernous transformation of the portal vein [J]. J Gastrointest Surg, 2007; 11(10)∶1322.
5. Ohnishi K, Okuda K, Ohtsuki T, et al. Formation of hilar collaterals or cavernous transformation after portal vein obstruction by hepatocellular carcinoma. Observations in ten patients [J]. Gastroenterology, 1984; 87(5)∶1150.
6. Gonen C, Akarsu M, Solmaz D, et al. Hodgkin’s disease presenting with chylous ascites and cavernous transformation of the portal vein [J]. Dig Dis Sci, 2007; 52(12)∶3511.
7. Lupescu I, Masala N, Capsa R, et al. CT and MRI of acquired portal venous system anomalies [J]. J Gastrointestin Liver Dis, 2006; 15(4)∶393.
8. 方驰华, 项楠, 范应方, 等. 64层螺旋CT三维成像在消化系统疾病诊治中的临床应用价值 [J]. 中华外科杂志, 2007; 45(13)∶909.
9. 齐立行, 杜国元, 陈佛来. 门静脉海绵样变(附2例报告) [J]. 中国实用外科杂志， 1998; 18（8）∶480.
10. Frutos Bernal MD, Fernández Hernández JA, Carrasco Prats M, et al. Portal-splenic-mesenteric venous thrombosis secondary to a mutation of the prothrombin gene [J]. Gastroenterol Hepatol, 2005; 28(6)∶329.
11. Miniati DN, Padidar AM, Kee ST, et al. Portal vein thrombosis after laparoscopic splenectomy: an ongoing clinical challenge [J]. JSLS, 2005; 9(3)∶335.
12. 杨镇, 刘飞龙, 戴植本, 等. 贲门周围血管离断术治疗门静脉高压症的疗效分析 [J]. 中华普通外科杂志, 1998; 13(2)∶74.
13. 杨灵, 肖渝清, 陈矢明, 等. 门静脉海绵样变的手术治疗 [J]. 腹部外科, 2003； 16(2)∶118.
14. Matsumoto H, Suzuki F, Souda K, et al. Improved long-term survival following complete eradication of esophageal varices by sclerotherapy [J]. Hepatogastroenterology, 1999; 46(25)∶172.
15. 曹农, 俞永江, 柴琛, 等. 门静脉高压症外科治疗185例 [J]. 肝胆胰外科杂志, 2008; 20(4)∶286.
16. Condino AA, Ivy DD, O’Connor JA, et al. Portopulmonary hypertension in pediatric patients [J]. J Pediatr, 2005; 147(1)∶20.
17. Warren WD, Henderson JM, Millikan WJ, et al. Management of variceal bleeding in patients with noncirrhotic portal vein thrombosis [J]. Ann Surg, 1988; 207(5)∶623.
18. Bambini DA, Superina R, Almond PS, et al. Experience with the Rex shunt (mesenterico-left portal bypass) in children with extrahepatic portal hypertension [J]. J Pediatr Surg, 2000; 35(1)∶13.
19. Wax JR, Pinette MG, Cartin A, et al. Cavernous transformation of the portal vein complicating pregnancy [J]. Obstet Gynecol, 2006; 108(3 Pt 2)∶782.
20. 赵龙栓, 范应中, 许培钦. 改良脾肺固定术治疗门静脉海绵样变性 [J]. 中国综合临床, 2003; 19(10)∶950.
21. 肖渝清, 胡先典. 门静脉海绵样变的手术治疗 [J]. 中华肝胆外科杂志, 2003; 9（10）∶625.
22. Walser EM, Soloway R, Raza SA, et al. Transjugular portosystemic shunt in chronic portal vein occlusion: importance of segmental portal hypertension in cavernous transformation of the portal vein [J]. J Vasc Interv Radiol, 2006; 17(2 Pt 1)∶373.
23. Senzolo M, Tibbals J, Cholongitas E, et al. Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with and without cavernous transformation [J]. Aliment Pharmacol Ther, 2006; 23(6)∶767.
24. 李德宇. 门静脉海绵样变性的外科诊断与治疗 [J]. 实用儿科临床杂志, 2005; 20(8)∶812.
25. 熊毅敏, 徐维田, 王一鸣，等. 门静脉海绵样变性11例临床分析 [J]. 实用医学杂志, 2005; 21(5)∶484.
26. 宋军民, 田丰, 李岩，等. 门静脉海绵样变性10例临床分析 [J]. 辽宁医学杂志, 2004; 18(2)∶93.
27. 旷历琼. 门静脉海绵样变性7例临床分析 [J]. 现代中西医结合杂志, 2007; 16（34）∶5109.
28. 花荣, 孙勇伟, 吴志勇. 联合手术治疗儿童门静脉海绵样变性肝前性门静脉高压症 [J]. 肝胆外科杂志, 2005; 13（6）∶428.
29. 张明满, 金先庆, 严律南, 等. 亲体肝移植治疗儿童门静脉海绵样变性3例临床分析　[J]. 中华肝脏病杂志, 2008; 16(4)∶270.
30. Hajdu CH, Murakami T, Diflo T, et al. Intrahepatic portal cavernoma as an indication for liver transplantation [J]. Liver Transpl, 2007; 13(9)∶1312.
31. Silva MA, Jambulingam PS, Gunson BK, et al. Hepatic artery thrombosis following orthotopic liver transplantation: a 10-year experience from a single centre in the United Kingdom [J]. Liver Transpl, 2006; 12(1)∶146.
32. Bauer J, Johnson S, Durham J, et al. The role of TIPS for portal vein patency in liver transplant patients with portal vein thrombosis [J]. Liver Transpl, 2006; 12(10)∶1544.
33. 王俊, 蔡威, 潘伟华，等. 肝移植治疗小儿先天性门静脉海绵样变 [J]. 上海交通大学学报(医学版), 2006; 26(6)∶643.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Current Status of Surgical Therapy for Cavernous Transformation of Portal Vein

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