RESUMO
Portal venous thrombosis was originally considered to be a contraindication for liver transplantation. Currently, several methods exist to re-establish blood flow to the hepatic portal system. Cavoportal hemitransposition is a surgical procedure that can be used in liver transplantation when the portal venous system is thrombosed and portal flow cannot be re-established from the mesenteric venous system. In cavoportal hemitransposition the blood flow from the inferior vena cava of the recipient is directed to the portal vein of the donor liver to compensate for the lost portal venous supply. This can either be done by end-to-end or end-to-side anastomosis. Seventy-one cases of cavoportal hemitransposition have been reported worldwide. All patients reported had been in a critical and life-threatening condition, presenting with either end-stage-liver disease or acute hepatic failure combined with severe vascular pathology. Of the cases reported, 32 patients died for reasons non-related to the surgical procedure. Seven of the 71 patients had Budd-Chiari syndrome complicated by thrombosis of the portal-venous system. This means thrombosis in two different venous systems at the same time, the mesenteric and main venous system. To date this <
Assuntos
Veias Hepáticas/cirurgia , Transplante de Fígado , Oclusão Vascular Mesentérica/cirurgia , Derivação Portocava Cirúrgica , Veia Porta/cirurgia , Circulação Esplâncnica , Veia Cava Inferior/cirurgia , Trombose Venosa/cirurgia , Síndrome de Budd-Chiari/fisiopatologia , Síndrome de Budd-Chiari/cirurgia , Circulação Colateral , Veias Hepáticas/fisiopatologia , História do Século XIX , História do Século XX , Humanos , Circulação Hepática , Oclusão Vascular Mesentérica/complicações , Oclusão Vascular Mesentérica/fisiopatologia , Derivação Portocava Cirúrgica/efeitos adversos , Derivação Portocava Cirúrgica/história , Veia Porta/fisiopatologia , Radiografia Intervencionista , Terminologia como Assunto , Resultado do Tratamento , Veia Cava Inferior/fisiopatologia , Trombose Venosa/complicações , Trombose Venosa/fisiopatologiaRESUMO
The historic evolution of Peruvian Surgery up to the application of experimentation is described, guiding it on a scientific path. It is evident that the beginning of Experimental Surgery and Laboratories were established, four decades ago, in Peruvian Universities; this enabled other surgical center to introduce new surgical procedures to medical practice. The first experiments in gastrointestinal surgery performed by a surgical school of the UNMSM and in the UPCH as well as their clinical applications in two Teaching Hospitals (Loayza and Cayetano Heredia) are reviewed.