Abstract:Objective
To investigate the indications for interventional therapy of BuddChiari syndrome(BCS) and surgical treatment after stent failure.
Methods A retrospective analysis of the clinical data of 21 patients with mistakes in treatment of BCS by stent placement in inferior vena cava(IVC).
Results Among the 21 cases with mistakes, the indications were inappropriately selected in 6 cases, the main hepatic vein was obstructed by the stent in 1 case, dilated accessory veins were occluded in 10 cases, the stent was displaced in 3 cases, and the stent failed to unfold in 1 case. Nineteen cases were converted to operation; of these patients, a shunt was performed in 18 cases, and radical excision of diaphragmatic web of IVC was done in 1 case. Operation was successful in all 19 cases. After shunt procedure in the 18 cases, the free portal pressure significantly decreased(P<0.05); no patient died perioperatively. 15 cases were followed up for 6 months to 6 years. The effective rate was 86.7%(13/15), recurrence rate was 6.7%(1/15), and 1 case died of hepatic encephalopathy.
Conclusions Indication for interventional therapy for BCS should be stricv.Various types of shunt can be selected for cases of mistakes or recurrences related to interventional therapy.