Surgical closure of congenital portosystemic shunts in children A modified classification for transitioning to minimal-invasive repair.

Congenital portosystemic shunts (CPSS) are rare malformations of visceral vessels that lead to poor or absent intrahepatic portal flow. Therapeutic options have shifted away from liver transplantation towards either interventional or surgical closure with excellent results. The challenge to reliably predict portal venous pressure response to shunt occlusion, paired with significant interindividual variability of shunt anatomy have hindered the structured transition from open to minimal invasive surgical shunt closure.