Mesocaval C-shunt plus ligation of splenic artery and esophagogastric (devascularization) in the treatment of type II Budd- Chiari syndrome
- VernacularTitle:肠系膜上-下腔静脉吻合联合脾动脉结扎、食管胃底周围血管离断治疗II型布-加综合征
- Author:
Fulin ZHANG
;
Bin WANG
;
Yongjiang XU
;
Yali CHEN
;
Peiqin XU
- Publication Type:Journal Article
- Keywords:
Hepatic Vein Thrombosis/surg;
Mesnteric Veins/surg;
Splenic Artery/surg;
Esophagogastric Devascularization
- From:
Chinese Journal of General Surgery
1997;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study a new operative method for treatment of hepatic venous occlasion without (associated) pathologic change of inferior vena cava or long-segment stricture. Methods A total of 44 cases of Budd-chiari syndrome with hepatic venous occlusion without pathologic change or long-segment stricture of (inferior) vena cava underwent combined mesocaval C-shunt, ligation of splenic artery, and esophagogastric (devascularization).Results Pre-shunt portal venous pressure was 36cmH2O(31~45 cmH2O, 1cmH2O=0.0098kPa) and post-shunt pressure fell to 26 cmH2O(21~33 cmH2O),the mean reduction was 10 cmH2O. One patient died of liver failure. A slight degree of hepatic encephalopathy occurred in 2patients who recovered after conservative treatment.Chylorrhea occurred in 4 patients, and it spontaneously disappeared 7d to 3.5months after operation. 39 patients(88.6% follow up) were followed up for 6months to 7years , and there was no case of recurrent bleeding nor hepatic encephalopathy. Ascites disappeared in 31cases,and was markedly reduced in 7 cases .The prosthetic grafts were patent as shown by color Doppler ultra sound in all followed-up patients.Conclusions This operation is simple and effective for B-CS with hepatic venous (occlusion) but not associated with inferior vena caval pathologic change or long-segment stricture.
