当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS期刊下所有文献 > Portosystemic shunts in children: a 15-year experience.

Portosystemic shunts in children: a 15-year experience.

Abstract：

BACKGROUND:The role of portosystemic shunt (PSS) in children with portal hypertension has changed because of acceptance of liver transplantation and endoscopic hemostasis. We report our experience with PSS, mainly the distal splenorenal shunt, to define its role in the management of variceal bleeding. STUDY DESIGN:From 1987 to 2002, 20 children with variceal bleeding after endoscopic therapy underwent PSS. Patient and database records were reviewed. RESULTS:There were 14 boys and 6 girls; mean age was 11 years (range 3 to 18 years). Seventeen distal splenorenal and three mesocaval venous interposition shunts were performed. There was no operative mortality, 19 patients were alive at a median followup of 31 months (range 4 to 168 months) without evidence of recurrent gastrointestinal bleeding. One patient underwent transplantation 2 years after PSS and 1 patient died of hepatic failure while awaiting transplantation. The cause of portal hypertension was portal vein thrombosis (n = 13), biliary atresia (n = 3), congenital hepatic fibrosis (n = 2), hepatitis C cirrhosis (n = 1), and Budd-Chiari syndrome (n = 1). Eighteen children were Child-Turcotte-Pugh class A and the remaining two were class B. One patient had two episodes of hematemesis after PSS. Two patients had worsening ascites. One patient had mild encephalopathy and one patient had shunt stenosis requiring angioplasty. CONCLUSIONS:PSS is a safe and durable therapy for pediatric patients with portal hypertension. Liver transplantation should be reserved for children with poor synthetic function associated with variceal bleeding. PSS may also serve as a bridge to transplantation in patients with preserved hepatic function. PSS, in particular the distal splenorenal shunt, has produced excellent results. This experience challenges the need for alternative forms of portal decompression.

journal_name

J Am Coll Surg

journal_title

Journal of the American College of Surgeons

authors

Botha JF,Campos BD,Grant WJ,Horslen SP,Sudan DL,Shaw BW Jr,Langnas AN

doi

10.1016/j.jamcollsurg.2004.03.024

keywords:

subject

Has Abstract

pub_date

2004-08-01 00:00:00

pages

179-85

issue

2

eissn

1072-7515

issn

1879-1190

pii

S1072-7515(04)00395-3

journal_volume

199

pub_type

杂志文章

相关文献

JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS文献大全
  • A bariatric surgery center of excellence: operative trends and long-term outcomes.

    abstract：BACKGROUND:Surgery remains the most effective intervention for obesity and its comorbidities. However, the long-term efficacy of bariatric procedures is rarely reported. This study addresses operative trends, efficiency, and long-term outcomes from a large bariatric program. STUDY DESIGN:Data were prospectively collec...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2014.01.056

    authors： Kruger RS,Pricolo VE,Streeter TT,Colacchio DA,Andrade UA

    更新日期：2014-06-01 00:00:00

  • Overexpression of c-myc messenger RNA in primary and metastatic lesions of carcinoma of the stomach.

    abstract：BACKGROUND:Although c-myc expression in carcinoma of the stomach has been reported to be involved in progression of the disease, little is known about the mechanism or significance of its expression. STUDY DESIGN:We measured c-myc messenger RNA (mRNA) levels by Northern blot hybridization in 51 primary gastric carcino...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：

    authors： Onoda N,Maeda K,Chung YS,Yano Y,Matsui-Yuasa I,Otani S,Sowa M

    更新日期：1996-01-01 00:00:00

  • The longitudinal study of surgical residents, 1993 to 1994.

    abstract：BACKGROUND:The American College of Surgeons (ACS) has collected comprehensive data about surgical residents for the past 12 years and has published an annual report, the Longitudinal Study of Surgical Residents. In 1994, the ACS and the American Medical Association (AMA) agreed to collaborate in collecting data about s...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：

    authors： Kwakwa F,Jonasson O

    更新日期：1996-11-01 00:00:00

  • No Survival Difference with Neoadjuvant Chemoradiotherapy Compared with Chemotherapy in Resectable Esophageal and Gastroesophageal Junction Adenocarcinoma: Results from the National Cancer Data Base.

    abstract：BACKGROUND:Neoadjuvant treatment improves survival in resectable esophageal adenocarcinoma, but the optimal regimen has not been defined. Neoadjuvant chemoradiation (nCRT) is associated with higher pathologic complete response (pCR) relative to chemotherapy (nCTX), but has not been shown to improve survival; however, p...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2016.09.002

    authors： Al-Sukhni E,Gabriel E,Attwood K,Kukar M,Nurkin SJ,Hochwald SN

    更新日期：2016-12-01 00:00:00

  • Autologous protein reinfusion in severe ovary hyperstimulation syndrome.

    abstract：BACKGROUND:Ovarian hyperstimulation syndrome (OHSS) is one of the most serious complications of ovulation induction by exogenous gonadotropins. The pathophysiologic factors of this syndrome are not well known. Increased capillary permeability causes third space fluid shift, which is responsible for ascites, pleural flu...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：

    authors： Splendiani G,Mazzarella V,Tozzo C,Elli M,Casciani CU

    更新日期：1994-07-01 00:00:00

  • Randomized trial of emergency endoscopic sclerotherapy versus emergency portacaval shunt for acutely bleeding esophageal varices in cirrhosis.

    abstract：BACKGROUND:The mortality rate of bleeding esophageal varices in cirrhosis is highest during the period of acute bleeding. This is a report of a randomized trial that compared endoscopic sclerotherapy (EST) with emergency portacaval shunt (EPCS) in cirrhotic patients with acute variceal hemorrhage. STUDY DESIGN:A total...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章,随机对照试验

    doi：10.1016/j.jamcollsurg.2009.02.059

    authors： Orloff MJ,Isenberg JI,Wheeler HO,Haynes KS,Jinich-Brook H,Rapier R,Vaida F,Hye RJ

    更新日期：2009-07-01 00:00:00

  • Hilar lobar vascular occlusion for hepatic resection.

    abstract：:Limited resection can be a therapeutic approach in patients with cirrhosis with very low remnant hepatic function after resection. In this study, two hilar vascular clamping methods (hilar selective clamping [n = 13] and hilar lobar clamping method [n = 8]), which were used for resection of hepatocellular carcinoma in...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：

    authors： Gotoh M,Monden M,Sakon M,Kanai T,Umeshita K,Nagano H,Mori T

    更新日期：1994-01-01 00:00:00

  • Assessment of transcutaneous bilirubinometry in hospitalized adults.

    abstract：BACKGROUND:Transcutaneous techniques to measure serum bilirubin have been validated in neonates but not in adult patients. We evaluated transcutaneous bilirubinometry (TcB) in adults at risk for or diagnosed with hepatic dysfunction to determine if this technology has clinical use in quantifying the presence and magnit...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2008.01.014

    authors： Harbrecht BG,Rosengart MR,Bukauskas K,Zenati MS,Marsh JW Jr,Geller DA

    更新日期：2008-06-01 00:00:00

  • Intraoperative assessment of colonic perfusion using scanning laser Doppler flowmetry during colonic resection.

    abstract：BACKGROUND:Ischemia occurring on mobilization and mesenteric division is thought to be a major factor in the etiology of anastomotic dehiscence after colorectal resection. This study assessed the ability of the new technique of scanning laser Doppler flowmetry to measure changes in human colonic perfusion during mobili...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/s1072-7515(00)00709-2

    authors： Boyle NH,Manifold D,Jordan MH,Mason RC

    更新日期：2000-11-01 00:00:00

  • Increased plasma fibrinogen level and future risk of coronary artery disease after repair of abdominal aortic aneurysm.

    abstract：BACKGROUND:Cardiovascular disease such as coronary artery disease is a major cause of late death after repair of abdominal aortic aneurysm (AAA). But risk factors are not well known. So, we investigated the incidence of cardiovascular events after surgery and examined the prognostic factors. STUDY DESIGN:We retrospect...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/s1072-7515(00)00759-6

    authors： Onohara T,Komori K,Kume M,Ishida M,Ohta S,Takeuchi K,Matsumoto T,Sugimachi K

    更新日期：2000-12-01 00:00:00

  • The migrated liver transplantation candidate: insight into geographic disparities in liver distribution.

    abstract：BACKGROUND:A minority of liver transplantation (LT) candidates pursue listing at multiple centers to achieve transplantation. The purpose of this study was to assess the characteristics and outcomes of the migrated LT candidates, that is, those who travel to secondary centers seeking LT. STUDY DESIGN:Single-center ret...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2013.12.056

    authors： Kohn R,Kratz JR,Markmann JF,Vagefi PA

    更新日期：2014-06-01 00:00:00

  • Surgeon as Double Agent: Perception of Conflicting Expectations of Patient Care and Stewardship of Resources.

    abstract：BACKGROUND:Physicians must satisfy 2 competing expectations: advocate for patients and serve as stewards of resources. No guidelines exist for surgeons on resolving this conflict. We surveyed surgeons' perceptions about these dual obligations. STUDY DESIGN:We conducted our study at 2 large university hospitals in 3 di...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2020.04.037

    authors： Kopar PK,Lui FY

    更新日期：2020-08-01 00:00:00

  • The influence of esophageal length on outcomes after laparoscopic fundoplication.

    abstract：BACKGROUND:It has been suggested that laparoscopic antireflux surgery has been associated with an increased incidence of postoperative paraesophageal hiatus herniation, and that this comes (at least in part) from not performing an esophageal lengthening procedure in patients with preoperative esophageal shortening. Thi...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/s1072-7515(00)00363-x

    authors： Yau P,Watson DI,Jamieson GG,Myers J,Ascott N

    更新日期：2000-10-01 00:00:00

  • Caval inflow to the graft: a successful way to overcome diffuse portal system thrombosis in liver transplantation.

    abstract：:Portal vein thrombosis was considered to be a major contraindication to liver transplantation before the introduction of vessel grafts from the recipient's area of confluence of the splenic and superior mesenteric veins, behind the neck of the pancreas, to the graft's portal vein. Refinement in surgical technique has ...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/s1072-7515(99)00299-9

    authors： Azoulay D,Hargreaves GM,Castaing D,Bismuth H

    更新日期：2000-04-01 00:00:00

  • Thyroglossal duct: a review of 55 cases.

    abstract：BACKGROUND:Thyroglossal duct remnants are the most common midline neck masses in childhood but can be found in adults and the elderly. Sistrunk's procedure, with dissection of the tract and removal of the hyoid bone, is accepted as the main operation of choice. STUDY DESIGN:Fifty-five patients were treated from Januar...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/s1072-7515(01)01171-1

    authors： Dedivitis RA,Camargo DL,Peixoto GL,Weissman L,Guimarães AV

    更新日期：2002-03-01 00:00:00

  • Heterogeneity in Trauma Registry Data Quality: Implications for Regional and National Performance Improvement in Trauma.

    abstract：BACKGROUND:Led by the American College of Surgeons Trauma Quality Improvement Program, performance improvement efforts have expanded to regional and national levels. The American College of Surgeons Trauma Quality Improvement Program recommends 5 audit filters to identify records with erroneous data, and the Georgia Co...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2015.11.035

    authors： Dente CJ,Ashley DW,Dunne JR,Henderson V,Ferdinand C,Renz B,Massoud R,Adamski J,Hawke T,Gravlee M,Cascone J,Paynter S,Medeiros R,Atkins E,Nicholas JM,GRIT Study Group.

    更新日期：2016-03-01 00:00:00

  • Peripheral ports are a new option for central venous access.

    abstract：BACKGROUND:Peripheral ports represent a new option for central venous access that have a low complication rate while providing long duration. This study provides five years of evaluation of this device. STUDY DESIGN:All patients had follow-up evaluation concurrently, with detailed information collected for the first 7...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：

    authors： Schuman E,Ragsdale J

    更新日期：1995-04-01 00:00:00

  • Reassessment of the current American Joint Committee on Cancer staging system for pancreatic neuroendocrine tumors.

    abstract：BACKGROUND:Adopting a unified staging system for pancreatic neuroendocrine tumors (PNETs) has been challenging. Currently, the American Joint Committee on Cancer (AJCC) recommends use of the pancreatic adenocarcinoma staging system for PNETs. We sought to explore the prognostic usefulness of the pancreatic adenocarcino...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2013.11.001

    authors： Qadan M,Ma Y,Visser BC,Kunz PL,Fisher GA,Norton JA,Poultsides GA

    更新日期：2014-02-01 00:00:00

  • Postoperative Care Using a Secure Online Patient Portal: Changing the (Inter)Face of General Surgery.

    abstract：BACKGROUND:Many patients seek greater accessibility to health care. Meanwhile, surgeons face increasing time constraints due to workforce shortages and elevated performance demands. Online postoperative care may improve patient access while increasing surgeon efficiency. We aimed to evaluate patient and surgeon accepta...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2015.08.429

    authors： Kummerow Broman K,Oyefule OO,Phillips SE,Baucom RB,Holzman MD,Sharp KW,Pierce RA,Nealon WH,Poulose BK

    更新日期：2015-12-01 00:00:00

  • Does enrollment in cancer trials improve survival?

    abstract：BACKGROUND:Stakeholders derive many benefits from cancer clinical trials, including guidance for future oncologic treatment decisions. However, whether enrollment in cancer trials also improves patient survival independently of trial outcomes remains underinvestigated. We hypothesized that cancer trial enrollment is no...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2012.12.036

    authors： Chow CJ,Habermann EB,Abraham A,Zhu Y,Vickers SM,Rothenberger DA,Al-Refaie WB

    更新日期：2013-04-01 00:00:00

  • Results from the cognitive changes and retirement among senior surgeons self-report survey.

    abstract：BACKGROUND:The Cognitive Changes and Retirement among Senior Surgeons (CCRASS) study suggested that although subjective cognitive awareness may play a role in surgeons' retirement decisions, self-perceived cognitive decline did not predict objective cognitive performance. This article summarizes results from all partic...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2009.08.004

    authors： Lee HJ,Drag LL,Bieliauskas LA,Langenecker SA,Graver C,O'Neill J,Greenfield L

    更新日期：2009-11-01 00:00:00

  • Placental umbilical cord whole blood transfusion: a safe and genuine blood substitute for patients of the under-resourced world at emergency.

    abstract：BACKGROUND:Afterbirth or placenta is normally discarded. But placental cord blood, because of its rich mix of fetal and adult hemoglobin, plasma, and high platelet count has the potential to be a safe alternative to adult blood. STUDY DESIGN:We transfused 413 U (range 50 mL to 146 mL; mean 86 mL+/-7.6 mL SD; median 80...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2004.12.007

    authors： Bhattacharya N

    更新日期：2005-04-01 00:00:00

  • Modes of presentation and management of inflammatory aneurysms of the abdominal aorta.

    abstract：:The preoperative diagnosis of inflammatory aneurysms of the abdominal aorta (IAAA) is seldom made, yet knowledge of its presence would be an aid to the surgeon. A heightened awareness of the variety of clinical presentations of IAAA should prompt the clinician to consider this entity in the differential diagnosis of b...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：

    authors： Curci JJ

    更新日期：1994-06-01 00:00:00

  • Appendicitis in children treated by pediatric versus general surgeons.

    abstract：BACKGROUND:Pediatric appendicitis is treated by both pediatric and general surgeons. We investigated whether specialty-dependent differences existed in patients' characteristics and outcomes. STUDY DESIGN:A retrospective chart review of 465 consecutive children treated for appendicitis at a university-affiliated child...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2006.10.006

    authors： Emil SG,Taylor MB

    更新日期：2007-01-01 00:00:00

  • Surgical management of acute right lower-quadrant pain in pregnancy: a prospective cohort study.

    abstract：BACKGROUND:The etiology of right lower-quadrant pain in pregnant patients is a challenge in diagnosis. We discuss the surgical issues among pregnant patients with right lower-quadrant pain and demonstrate the method to diagnosis. STUDY DESIGN:This was a prospective cohort study with enrollment during 2 years. Pregnant...

    journal_title：Journal of the American College of Surgeons

    pub_type： 临床试验,杂志文章

    doi：10.1016/j.jamcollsurg.2010.06.004

    authors： Butala P,Greenstein AJ,Sur MD,Mehta N,Sadot E,Divino CM

    更新日期：2010-10-01 00:00:00

  • Laparoscopic repair of lumbar hernias.

    abstract：BACKGROUND:Lumbar hernias are rare defects in the posterolateral abdominal wall that may be congenital or acquired. Repairing these defects is difficult by virtue of their location and the inherent weakness of the surrounding tissues. We report a series of seven patients who had their lumbar hernias repaired laparoscop...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/s1072-7515(98)00124-0

    authors： Arca MJ,Heniford BT,Pokorny R,Wilson MA,Mayes J,Gagner M

    更新日期：1998-08-01 00:00:00

  • Impact of cirrhosis on outcomes in trauma.

    abstract：BACKGROUND:Cirrhosis as an independent predictor of poor outcomes in trauma patients was identified in 1990. We hypothesized that the degree of preinjury hepatic dysfunction is, by itself, an independent predictor of mortality. STUDY DESIGN:The trauma registry at our Level I trauma center was queried for all ICD-9 cod...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2006.08.001

    authors： Dangleben DA,Jazaeri O,Wasser T,Cipolle M,Pasquale M

    更新日期：2006-12-01 00:00:00

  • Management of sterile necrosis in instances of severe acute pancreatitis.

    abstract：BACKGROUND:The clinical management of sterile pancreatic necrosis is still a matter of debate. In this study we analyzed the clinical course and outcome of patients with sterile necrotizing pancreatitis treated surgically versus nonsurgically. STUDY DESIGN:Between May 1982 and December 1993, 249 patients with necrotiz...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：

    authors： Rau B,Pralle U,Uhl W,Schoenberg MH,Beger HG

    更新日期：1995-10-01 00:00:00

  • The Turkish experience with curative gastrectomies for gastric carcinoma: is D2 dissection worthwhile?

    abstract：BACKGROUND:The only possible curative treatment in gastric carcinoma is surgery, and there is still controversy surrounding the value of extended lymph node dissection. STUDY DESIGN:A retrospective cohort study was conducted in patients who underwent curative D1 or D2 resection for operable gastric carcinoma. Survival...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/s1072-7515(00)00779-1

    authors： Yildirim E,Celen O,Berberoglu U

    更新日期：2001-01-01 00:00:00

  • Sterility of the surgical site marking between the ink and the epidermis.

    abstract：BACKGROUND:To prevent wrong-site surgery, multiple organizations have endorsed the practice of signing the operative site with an indelible marker. Potential contamination of the surgical field and the inability to prepare the area under the ink film raises concerns. The purpose of this study was to determine if the us...

    journal_title：Journal of the American College of Surgeons

    pub_type： 杂志文章

    doi：10.1016/j.jamcollsurg.2007.02.029

    authors： Cullan DB 2nd,Wongworawat MD

    更新日期：2007-08-01 00:00:00