Right Porto-Ovarian H-Shunt for the Surgical Treatment of Symptomatic Portal Biliopathy: A Case Report and Literature Review
Table 1
Clinical course of the patient.
Date
Pathological condition
Management
10.2003
Idiopathic extrahepatic portal and superior mesenteric vein thrombosis, because of elevated factor VIII level, complicated with portal hypertension
Administration of phenprocoumon for anticoagulation (discontinued because of episodes of variceal bleeding), and beta-blocker and nitrate for portal hypertension
12.2003
Bleeding episodes from grade II oesophageal varices
Endoscopic sclerotherapy
04.2004
Grade I portal biliopathy
Endoscopic complete bile duct stone clearance and insertion of a biliary endoprosthesis, administration of ursodesoxicholic acid
06.2004–02.2007
Numerous relapsing episodes of symptomatic portal biliopathy
Multiple ERCP sessions and stent changes without a definitive improvement
04.2007
Symptomatic portal biliopathy- decision making for surgical management
Open cholecystectomy and an alternative portosystemic shunt (right porto-ovarian H-shunt)
05.2007–present
None. The patient did not developed encephalopathy while she has had no further episodes of bleeding, jaundice, abdominal pain, or recurrent fever
