Transjugular intrahepatic portosystemic shunts in children with biliary atresia.
(2002) Cardiovascular and Interventional Radiology — Vol. 25, n° 6, p. 484-493 (2002)
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- PURPOSE: We retrospectively evaluated the technical and long-term clinical results of transjugular intrahepatic portosystemic shunts (TIPS) in children with portal hypertension and biliary atresia (BA). METHODS: Nine children with BA and recurrent bleeding from esophagogastric and/or intestinal varices were treated by TIPS at the age of 34-156 months and followed-up in two centers. Different types of stents were used. RESULTS: Shunt insertion succeeded in all patients, but in two a second procedure was necessary. Seven procedures lasted more than 3 hr, mainly due to difficult portal vein puncture. Variceal bleeding ceased in all patients; however, 16 reinterventions were performed in eight patients for clinical reasons (n = 11) and sonographically suspected restenosis (n = 5). Four patients underwent successful liver transplantation 4-51 months after TIPS and five are in good clinical conditions 64-75 months after TIPS. CONCLUSION: TIPS in children with BA is technically difficult, mainly due to periportal fibrosis and small portal veins. Frequency of reinterventions seems to be higher compared with adults.
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Huppert, P. E., Goffette, P., Astfalk, W., Sokal, E. M., Brambs, H.-J., Schott, U., Duda, S. H., Schweizer, P., & Claussen, C. D. (2002). Transjugular intrahepatic portosystemic shunts in children with biliary atresia. Cardiovascular and Interventional Radiology, 25(6), 484-493. https://doi.org/10.1007/s00270-002-1913-1 (Original work published 2002)