{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T23:08:44Z","timestamp":1784243324823,"version":"3.55.0"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"DOI":"10.13039\/501100018555","name":"Science and Technology Program of Guizhou Province","doi-asserted-by":"crossref","award":["LC[2024]107"],"award-info":[{"award-number":["LC[2024]107"]}],"id":[{"id":"10.13039\/501100018555","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100017957","name":"Health Commission of Guizhou Province","doi-asserted-by":"crossref","award":["gzwkj2024-430"],"award-info":[{"award-number":["gzwkj2024-430"]}],"id":[{"id":"10.13039\/100017957","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To report our institutional experience with a portal venous pressure (PVP)-guided surgical strategy for congenital portosystemic shunts (CPSs) and introduce a novel bedside ligation technique for staged shunt closure.<\/jats:p>\n                  <jats:p>We retrospectively reviewed 20 children who underwent surgical CPS closure between 2013 and 2023. The surgical approach was determined by intraoperative PVP during temporary shunt occlusion. One-stage ligation was performed when PVP remained\u2009&lt;\u200925\u2009mm Hg, whereas shunts with PVP \u2265 25\u2009mm Hg were banded for staged closure using either bedside ligation or endovascular completion.<\/jats:p>\n                  <jats:p>Fourteen patients (70%) underwent one-stage closure (median PVP: 22.0\u2009mm Hg, interquartile range [IQR]: 18.0\u201322.5), and six (30%) required two-stage closure (median PVP: 28.0\u2009mm Hg, IQR: 25.8\u201329.5). Among the latter, five achieved complete shunt occlusion through the bedside technique, avoiding reoperation or readmission. The primary composite outcome\u2014radiologic closure, fasting blood ammonia normalization, and absence of severe complications\u2014was achieved in all 20 patients (100%) at 1-year follow-up. Significant intrahepatic portal vein (IPV) remodeling was observed, with median left and right IPV diameters increasing from 1.4 and 1.6 to 4.8 and 5.0\u2009mm, respectively (both p\u2009&lt;\u20090.0001). The overall complication rate was 15% (3\/20), all Clavien\u2013Dindo Grades I to II.<\/jats:p>\n                  <jats:p>In children with CPSs unsuitable for endovascular closure, a PVP-guided surgical strategy appears safe and effective. For those requiring two-stage closure due to elevated PVP, bedside ligation after Endoloop banding provides a feasible, less invasive alternative to reoperation. However, larger studies are needed to confirm its safety and efficacy.<\/jats:p>","DOI":"10.1055\/a-2789-0007","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:07:52Z","timestamp":1768608472000},"page":"330-338","source":"Crossref","is-referenced-by-count":0,"title":["Novel Bedside Ligation for Staged Closure of Congenital Portosystemic Shunts: A Single-Center Experience in 20 Children"],"prefix":"10.1055","volume":"36","author":[{"given":"Sheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"},{"name":"Department of General Surgery, Guizhou Branch of Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Guiyang, Guizhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaying","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhoulonglong","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongyu","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qimin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7433-5730","authenticated-orcid":false,"given":"Zhilong","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1007\/s00261-018-1619-8","article-title":"Congenital portosystemic shunts: diagnosis and treatment","volume":"43","author":"S Franchi-Abella","year":"2018","journal-title":"Abdom Radiol (NY)"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.5152\/dir.2021.20474","article-title":"Abernethy malformation: A comprehensive review","volume":"28","author":"P 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