Laparoscopic ligation of a congenital extrahepatic portosystemic shunt for children with hyperammonemia: a single-institution experience

Takama, Yuichi; Ueno, Takehisa; Umeda, Satoshi et al.

Surgery Today, 2019, 49, 323-327

Number of Access:798（2025-07-22 21:55 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/100069

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Title
Laparoscopic ligation of a congenital extrahepatic portosystemic shunt for children with hyperammonemia: a single-institution experience
Creator
NRID
1000050467560 1000050467560
researchmap permalink
tytyty_ytytyt tytyty_ytytyt
CreatorName
Takama, Yuichi
NRID
1000010456957 1000010456957
ORCID
0000-0002-4639-8814 0000-0002-4639-8814
researchmap permalink
ueno-pedsurg ueno-pedsurg
Scopus Author ID
21743992300 21743992300
CreatorName
Ueno, Takehisa
NRID
1000060715176 1000060715176
CreatorName
Umeda, Satoshi
NRID
1000000459190 1000000459190
ORCID
0000-0001-8960-8618 0000-0001-8960-8618
researchmap permalink
sakaryuta sakaryuta
CreatorName
Saka, Ryuta
NRID
1000010397698 1000010397698
researchmap permalink
yukotazuke-osaka yukotazuke-osaka
Scopus Author ID
7006109798 7006109798
ORCID
0000-0002-8335-0414 0000-0002-8335-0414
CreatorName
Tazuke, Yuko
NRID
1000030252670 1000030252670
researchmap permalink
okuyamahiroomi okuyamahiroomi
Scopus Author ID
35496082300 35496082300
ORCID
0000-0002-1347-282X 0000-0002-1347-282X
CreatorName
Okuyama, Hiroomi
Subject
Congenital extrahepatic portosystemic shunt
Congenital portosystemic shunt
Hyperammonemia
Hypermanganesemia
Laparoscopic
Description
This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s00595-018-1731-y.
Abstract
Purpose: A congenital extrahepatic portosystemic shunt (CEPS) associated with hyperammonemia requires occlusion of the shunt vessels. We evaluated the effectiveness and safety of laparoscopic ligation of a CEPS in children with hyperammonemia. Methods: The subjects of this retrospective study were seven children with hyperammonemia who underwent laparoscopic ligation of a CEPS. Their median age was 5.2 years (range 1–16 years). Before the laparoscopic procedure, a catheter was inserted through the femoral vein and placed in the portal vein via the shunt vessel. The shunt vessel was dissected and taped laparoscopically. After measuring the portal vein pressure under temporal occlusion, the shunt vessels were ligated. Results: The types of shunts according to location were patent ductus venosus (n = 2), splenorenal shunt (n = 2), gastrorenal shunt (n = 2), and superior mesenteric vein–inferior vena cava shunt (n = 1). Laparoscopic ligation of the shunt vessel was completed uneventfully in all patients. The median portal vein pressure was 19 mmHg after ligation. The median preoperative blood ammonia level was 94 µg/dL (range 71–259 µg/dL), which decreased after ligation in all patients. There was no incidence of postoperative liver failure. Conclusion: Laparoscopic ligation of a CEPS is safe and effective for children with hyperammonemia.
Publisher
Springer Nature
Source Title
Surgery Today
Volume (Issue)
49
Page
323-327
Date of Issued
2019-04-10
Language
English
Handle URL
https://hdl.handle.net/11094/100069
PISSN
09411291
eISSN
14362813
Relation.isVersionOf
DOI (Publisher Version)
https://doi.org/10.1007/S00595-018-1731-Y
Access Rights
open access
CopyRight
© 2018, Springer Nature Singapore Pte Ltd.
oaire:version
Accepted Manuscript
Category
学術雑誌論文 Journal Article