{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T05:48:45Z","timestamp":1775886525161,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Extrahepatic portal vein obstruction (EHPVO) is among the main causes of childhood portal hypertension. We analysed nationwide long\u2010term outcomes of EHPVO in relation to various management options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In total, 62 consecutive patients with EHPVO diagnosed between 1987 and 2023 were followed up through hospital records and national health care registries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median follow\u2010up age was 18.8 (13.1\u201327.1) years. Oesophageal varices (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200960, 97%) were diagnosed at median age 5.5 (3.4\u20137.6) years. Overall, patients underwent 9 (4\u201315) gastroscopies and 6 (4\u201310) sclerotherapies\/band ligations. Thirty\u2010six (58%) patients experienced median 1 (1\u20133) variceal bleeds. Forty\u2010nine (79%) patients underwent 56 shunt procedures with overall 86% (42\/49) patency rate. Patients receiving primary mesoportal bypass (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200936) since 2002, underwent median 8 (4\u201312) upper endoscopies compared to 25 (9\u201327) among those without shunt surgery (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). During the last 5\u2009years of follow\u2010up 3 (5%) patients experienced variceal bleeding: 1\/49 after shunt surgery and 2\/13 without shunt surgery (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.09). Thrombocytopenia had resolved in 76% of patients with patent shunts compared to 33% with occluded shunts. Six (10%) patients developed symptomatic portal hypertensive biliopathy at median age 18.8 (12.0\u201324.2) years, none of whom had a functioning shunt (6\/6 vs. 41\/56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and 5 of whom had undergone splenectomy (5\/6 vs. 3\/56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Surgical shunts prevented variceal bleeding effectively in the long\u2010term, and mesoportal bypass reduced the number of endoscopic interventions. Previous splenectomy and absence of a functioning shunt were associated with the development of portal hypertensive biliopathy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70583","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:37:24Z","timestamp":1773038244000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Outcomes of Extrahepatic Portal Vein Obstruction\u2014A Nationwide Registry\u2010Based Follow\u2010Up Study From 1987 to 2023"],"prefix":"10.1111","volume":"46","author":[{"given":"Topi","family":"Luoto","sequence":"first","affiliation":[{"name":"Pediatric Liver and Gut Research Group, Pediatric Research Center, New Children's Hospital University of Helsinki and Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Pediatric Surgery Tampere University Hospital  Tampere Finland"},{"name":"Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Hukkinen","sequence":"additional","affiliation":[{"name":"Pediatric Liver and Gut Research Group, Pediatric Research Center, New Children's Hospital University of Helsinki and Helsinki University Hospital  Helsinki Finland"},{"name":"Section of Pediatric Surgery, New Children's Hospital Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikko P.","family":"Pakarinen","sequence":"additional","affiliation":[{"name":"Pediatric Liver and Gut Research Group, Pediatric Research Center, New Children's Hospital University of Helsinki and Helsinki University Hospital  Helsinki Finland"},{"name":"Section of Pediatric Surgery, New Children's Hospital Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Women's and 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