Operative Interventions for Extrahepatic XXXX and Long-Term Outcomes.

@entity1 @entity939 @entity548 @entity439 @entity736 @entity715
BACKGROUND: @entity439 (PVAs) are rare, and the pathogenesis is not fully understood. The optimum management of these @entity1 is unknown. METHODS: Consecutive @entity1 with @entity939 were identified over an 18-year period (1992-2010). A retrospective review was conducted. Clinical presentation, modality of diagnosis, surgical treatment, 30-day morbidity and mortality, and follow-up are reported. RESULTS: Four @entity1 were identified who underwent surgical management of an extrahepatic @entity939 . Operative technique using left renal vein, femoral vein panel graft, @entity736 (ePTFE) graft, and segmental @entity439 wall resected with aneurysmorrhaphy is described. Early complications occurred in 1 @entity1 with an ePTFE graft. The @entity1 returned to the operating room for @entity548 . In addition, the same @entity1 had a late graft @entity715 6 years postoperatively when the anticoagulation was discontinued for pregnancy. The remainder of the @entity1 recovered without complication, and their repairs are still patent with a mean follow-up of 78  months (17-144  months). There were no mortalities in the series. CONCLUSIONS: Operative intervention for portomesenteric @entity439 can be done safely in select @entity1 and should be considered in those with symptoms, rapid growth, mural @entity715 , or @entity439 >= 4  cm in diameter. Repair with an autogenous interposition graft affords good long-term patency. Aneurysmorrhaphy may be performed if the remaining venous wall is of good quality.
