Emergent Meso-Rex shunt to treat intraoperative unrepairable portal vein rupture: a case report

Xiangfei Meng, W. Duan, Yingwei Pan, X. Shi, Zhiqiang Wang, Ya-dong Sun, Shi-xin Lu
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Abstract

报道首例术中紧急Meso-Rex分流术治疗不可修复的门静脉破裂。患者男性,68岁,因"脂肪肉瘤切除术后复发"入院。诊断为复发性脂肪肉瘤拟行手术切除。肿瘤位于门静脉主干后方,被下腔静脉、腹腔干、肠系膜上动脉等重要血管包绕。术中分离肿瘤时,门静脉后壁破裂,破口直达脾静脉汇合至肠系膜上静脉处,无法修复,被迫封闭门静脉主干。为纠正急性肝前型门静脉高压,以人工血管行Meso-Rex分流术,成功恢复门静脉血流。术后患者恢复顺利,至今随访1年余生存良好。
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紧急Meso-Rex分流术治疗术中不可修复的门静脉破裂1例
Report the first intraoperative emergency Meso Rex shunt for the treatment of irreparable portal vein rupture. The patient, a 68 year old male, was admitted due to "recurrence after liposarcoma resection". Diagnosed as recurrent liposarcoma, surgical resection is planned. The tumor is located behind the main portal vein and is surrounded by important blood vessels such as the inferior vena cava, abdominal trunk, and superior mesenteric artery. During the surgical separation of the tumor, the posterior wall of the portal vein ruptured, leading directly to the confluence of the splenic vein and the superior mesenteric vein, which could not be repaired and forced to seal the main portal vein. To correct acute prehepatic portal hypertension, a Meso Rex shunt was performed using an artificial blood vessel to successfully restore portal vein blood flow. The postoperative patient recovered smoothly and has been followed up for more than 1 year with good survival.
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来源期刊
中华肝胆外科杂志
中华肝胆外科杂志 Medicine-Gastroenterology
CiteScore
0.20
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0.00%
发文量
7101
期刊介绍: Chinese Journal of Hepatobiliary Surgery is an academic journal organized by the Chinese Medical Association and supervised by the China Association for Science and Technology, founded in 1995. The journal has the following columns: review, hot spotlight, academic thinking, thesis, experimental research, short thesis, case report, synthesis, etc. The journal has been recognized by Beida Journal (Chinese Journal of Humanities and Social Sciences). Chinese Journal of Hepatobiliary Surgery has been included in famous databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Source Journals of China Science Citation Database (with Extended Version) and so on, and it is one of the national key academic journals under the supervision of China Association for Science and Technology.
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