Text Box: RESULTS OF OPERATIONS TO CHILDREN WITH EXTRA-HEPATIC BLOCKAGE OF PORTAL BLOOD CIRCULATION 
Arynov NM, Shirtaev BK, Kojabergenov AB, Kalibekov KJ, Ibrahim M
Scientific Center of Surgery, Almaty, Republic of Kazakhstan

Our clinic from 1994 has experience of surgical treatment of 54 patients, 1 to 19 years old, with extra-hepatic form of portal hypertension. The diagnostic methods are: fiber optic oesophago-gastroscopy, USS of the parenchymal organs with dopplergraphy of the portal blood vessels and inferior vena cava, with left renal vein, returned spleenic and mesenteric portography. On these, we found out that blocks were on: portal vein in [45], splenic vein eight, combined blocks one.To these patients, these operations were done: proximal splenorenal shunt [15] patients, out of them with gastrorenopexy 3 patients. Ligations of left gastric artery to 4, suturing of cardiac vein Partior procedure- 5. Subcardiac gastrotomy- Tanners procedure 2, distal splenorenal shunt 2. Splenorenal shunt side to side 3, splenectomy 6, mesentericocaval shunt H- graft 6. To all of these patients, there was an additional ligation of coronary vein of the stomach and denervation of the common renal artery. No death recorded. Three of the patients had residual oesophagogastric bleeding, as a result, angiograph was performed. One of the patients had thrombosis of the proximal splenorenal anastomosis, the shunts of other two patients were functioning fine. The last situation proved the inadequate functioning of the shunt and presence of collateral veins in gastro-oesophageal zone. These patients had re-operation with creation of mesentericocaval shunt end to side.

Therefore, porto-caval shunt is the radical procedure for patients with portal hypertension, its effect is connected with optimal choice of shunt operations based upon knowledge and angioarchitectural properties of the portal systems.

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