[The effect of internal jugular vein ligation on cerebral circulation in children with extrahepatic portal hypertension]. / Vliianie na mozgovoe krovoobrashchenie pereviazki vnutrennei iaremnoi veny u detei s nepechenochnoi portal'noi gipertenziei.

The menesterico-caval H-bypass using right internal jugular vein was performed in 63 children with extrahepatic portal hypertension. Two group of patients were divided as follows: 45 children in the first group had H-bypass operation with the use of right internal jugular vein. In 23 children of the second group bypass operations without dissection of internal jugular vein were performed. The age of children was between 1, 5 and 14 years. Various methods have been used to estimate the impact of one jugular vein ligation on CNS and cerebral blood supply: electroencephalogram, echoencephalography, rheoencephalography. The tests have been done prior the operation, 1-3 weeks after the operation and a year after it. All children had Doppler test before the operation to make sure that both jugular veins are permeable. 80% of patients had different kind of functional cerebral changes. In 90% of cases intracranial pressure and tone of microvascular bed were increased. One-sided ligation of the internal jugular vein in children does not cause cerebral hemodynamic and liquor-dynamic disorders and does not influence functional status of brain in the short-term and long-term postoperative period.

[Portal hypertension in children: venous shunting in the early childhood]. / Portalnaia gipertenziia u detei: opyt venoznogo shuntirovaniia v rannem detskom vozraste.

Operations were carried out on 98 children with extrahepatic portal hypertension and on 6 with intrahepatic block and no signs of hepatocellular insufficiency. Mesenterico-caval H-shunt was formed in 78 children with the use of the internal jugular vein as the insert. The remaining children underwent formation of mesocaval anastomosis (8), distal spleno-renal shunt (4), portocaval anastomosis (1), Sugiura's operation (7). Among the operations 68 were planned, 12 emergency, and 18 preventive. The average age of the children was 6.5 years; 31 were under the age of 5 years and 19 under 3 years of age. The youngest child was aged 10 months, the H-shunt was successful. The results of the operation: thrombosis of the shunt 0%, portosystem encephalopathy 0%, recurrent hemorrhage 0%, lethality 1%. This is evidence of the expediency of performing shunting operations in early childhood.