Clinical value of preventative surgical resection in the treatment of extra-hepatic portal vein aneurysm
10.3760/cma.j.issn.1673-9752.2017.11.015
- VernacularTitle:预防性切除术治疗肝外型门静脉瘤的临床价值
- Author:
Shutong LU
1
;
Miaoshui PU
;
Feng HUO
;
Xiao LIU
Author Information
1. 510010,广州军区广州总医院肝胆外科肝脏移植中心
- Keywords:
Portal vein aneurysm,extra-hepatic;
Surgical procedures,operative;
Preventability;
Portal vein aneurysm resection
- From:Chinese Journal of Digestive Surgery
2017;16(11):1149-1153
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical value of preventative surgical resection in the treatment of extra-hepatic portal vein aneurysm.Methods The method of retrospective descriptive study was conducted.The clinical data of 1 patient with extra-hepatic portal vein aneurysm who was admitted to the Guangzhou General Hospital of Guangzhou Military Command of PLA in May 2014 were collected.The patient suffered from dull pain in his epigastrium,with no obvious causative factors.The patient recieved abdominal B-ultrasound,CT scans abdominal and superior mesenteric artery,angiographies after admission in May 2014,and was diagnosed as with extra-hepatic portal vein aneurysm.The preventative surgical resection was selected according to the patient's individual health status.Extra-hepatic portal vein aneurysm resection was conducted under the guidance of intraoperative ultrasonography after abdominal exploration.A double-cavity drainage tube was placed in the venturis hole when portal vein aneurysm was dissected and removed.Then the abdomen was closed.The patient received regular perioperative management.The operation time,volume of intraoperative blood loss,time for diet recovery,time of drainage tube removal,postoperative complications,results of laboratory tests,results of imaging findings,healing of incision,time of postoperative discharge from hospital,results of pathologic examination and follow-up were observed.Follow-up using outpatient examination or telephone interview was performed to detect the inspect status of portal vein and inspect recurrence of portal vein aneurysm by abdominal B-ultrasound and CT examinations till December 2014.Results The patient underwent successful extra-hepatic portal vein aneurysm resection.The operation time was 85 minutes and the volume of intraoperative blood loss was around 150 mL.The patient gradually returned to normal diet and self-care ability at postoperative day 3,and the abdominal drainage tube was removed at postoperative day 3.No postoperative complications including hemorrhage,portal vein thrombosis and dysfunction of liver were detected after operation.There were normal levels of blood routine and blood biochemical test.Postoperative B-ultrasound examination showed smooth blood flow in portal vein and the abdominal blood vessel CT angiography presented clear image of the portal vein,with smooth blood flow and normal lumen.The surgical incision recovered very well and the patient was discharged from hospital at postoperative day 9.Results of postopeartive pathologic examination showed that there were cystic-like tissues with simple squamous epithelium cells on the interior,the wall of which consisted of smooth muscle was in accordance of the structure of vein.The patient didn't receive any other special treatment or take medicines postoperatively.The patient had good physical health and can take care of himself during six-month follow-up,without narrow portal vein,recurrence of portal vein aneurysm and other complications.Conclusion Preventative surgical resection is safe and feasible for extra-hepatic portal vein aneurysm,with a good efficacy.
