Clinical analysis of percutaneous variceal embolization in children with portal hypertension at high risk of esophagogastric variceal bleeding
10.3760/cma.j.cn113884-20231201-00149
- VernacularTitle:经皮曲张静脉栓塞术治疗门静脉高压食管胃静脉曲张出血高风险的患儿疗效分析
- Author:
Wenjuan ZHU
1
;
Mingman ZHANG
;
Ruijue WANG
;
Xiaoke DAI
;
Qiang XIONG
Author Information
1. 重庆医科大学附属儿童医院肝胆外科 国家儿童健康与疾病临床医学研究中心 儿童发育疾病研究教育部重点实验室 结构性出生缺陷与器官修复重庆市重点实验室，重庆 400014
- Keywords:
Hypertension, portal;
Child;
Percutaneous variceal embolization;
Esophagogastric variceal bleeding
- From:
Chinese Journal of Hepatobiliary Surgery
2024;30(7):525-530
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the efficacy of percutaneous variceal embolization (PTVE) in children with portal hypertension at high risk of esophageal variceal bleeding.Methods:Clinical data of 14 children undergoing PTVE in Children's Hospital Affiliated to Chongqing Medical University from October 2018 to May 2023 were retrospectively analyzed, including 9 males and 5 females, with a median age of 1 years and 11 months, ranging from 7 months to 12 years and 10 months. The causes of portal hypertension were portal vein spongiosis in 5 cases, portal vein anastomotic stenosis after liver transplantation in 7 cases and decompensated cirrhosis in 2 cases. PTVE was performed in all patients. The surgical approach, intraoperative portal vein pressure, complications, prognosis, and gastrointestinal bleeding were analyzed.Results:The portal vein pressure was (21.3±4.1) mmHg (1 mmHg=0.133 kPa), ranging from 15.8 to 28.6 mmHg. PTVE was successfully completed in all cases, with 11 cases by hepatic approach and 3 cases by splenic approach. All patients were embolized without puncture bleeding. Among the 5 cases with portal vein spongiosis, Meso-Rex was performed in 4 cases from 1 to 27 months after PTVE, and liver transplantation was performed in 1 case 11 months after PTVE for there was no indication of Meso-Rex. Balloon dilatation was performed during embolization in 7 patients with portal vein anastomotic stenosis after liver transplantation. Two cases of decompensated cirrhosis underwent liver transplantation at 3 months and 7 months after embolization, respectively. All children were followed up for 5 to 60 months, and no death occurred, two cases had gastrointestinal bleeding.Conclusion:PTVE could be an effective minimally invasive treatment for children with portal hypertension at high risk of esophageal and gastric varices bleeding, and the incidence of posttreatment gastrointestinal bleeding rate is low.
