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 36cmH2O(31~45 cmH2O, １cmH2O=0.0098kＰa) and postshunt pressure fell to 26 cmH2O(21~33 cmH2O),the mean reduction was 10 cmH2O. 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.