The effectiveness of alternative vessel grafts for meso-rex bypass in the treatment of extrahepatic portal vein obstruction in children

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Key takeaways

• Alternative autologous vessel grafts are effective for Meso-Rex bypass in pediatric EHPVO, offering physiologic portal flow restoration.
• MRB patients showed significant ammonia level reduction post-op, while DSRS patients experienced increased ammonia levels.
• Gastric coronary vein grafts carry higher thrombosis risk; careful graft selection is critical for MRB success.
• MRB is preferred for younger children with variceal bleeding; DSRS remains viable when MRB is anatomically unfeasible.
• Both procedures effectively resolve variceal bleeding and hypersplenism in pediatric portal hypertension.

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