布－加综合征的外科治疗：附172例报告

Objective To study the pathologic features, the clinicopathologic classification, rational diagnosis, and methods and principles of surgical treatment of Budd-Chiari syndrome (B-CS). Methods The clinical data of 172 cases of B-CS treated by surgery were retrospectively analyzed. Results All the 172 cases of B-CS underwent operation or the combination of operation and interventional therapy, including: (1) percutaneous transluminal angioplasty (PTA) and/or stenting of the inferior vena cava (IVC) in 99 cases; (2) percutaneous transhepatic angioplasty and/or stenting of the hepatic venous in 10 cases; (3) cavocaval shunt in 7 cases; (4) modified splenopneumopexy in 12 cases; (5) trans right atrium finger or balloon membranotomy in 5 cases; (6) radical resection of membrane and thrombus in 5 cases; (7) mesocaval shunt in 11 cases; (8) mesojugular shunt in 3 cases; (9) mesoatrium shunt in 5 cases; (10) IVC-atrium shunt in 4 cases; (11) mesocaval shunt combined with PTA and stenting of the IVC in 5 cases. Operative death rate was 1.2% (2/172). During the follow up period of 3 months to 7 years, 12 patients had recurrence (7.0%), of whom 4 died of hepatic failure, and the other patients recovered satisfactorily. Conclusions Various imaging techniques should be adopted to make a definite diagnosis of Budd-Chiari syndrome before operation. Different operative procedures should be used according to the distinct clinicopathologic type of Budd-chiari syndrome.