胆道多次手术合并肝硬化门静脉高压症的评估及处理

目的 探讨胆道多次手术同时合并肝硬化门静脉高压症的评估及处理.方法 回顾性分析2005年1月至2008年12月我院收治的18例胆道多次手术同时合并肝硬化门静脉高压症患者的临床资料.结果 18例胆道多次手术同时合并肝硬化门静脉高压症患者中,按照Child-Pugh分级,A级4例,B级10例,C级4例.肝硬化原因:胆汁性肝...

Assessment and management of biliary tract re-operation accompanied with hepatocirrhosis and portal hypertension

Objective To probe the assessment and management of biliary tract re-operation accompanied with hepatocirrhosis and portal hypertension.Methods The clinical data of 18 patients of bile duct re-operation accompanied with hepatocirrhosis and portal hypertension from January 2005 to December 2008 were retrospectively analyzed.Results Of the 18 patients,4 were grouped to Child A according to Child-Pugh classification,10 were child B,another 4 were Child C.As to the causes of hepatocirrhosis: 14 patients(77.8%) resulted from biliary cirrhosis,2 posthepatitic cirrhosis,2 schistosomiasis cirrhosis.Sixteen patients received simply biliary tract re-operation,2 received biliary tract re-operation with devascularization;the bleeding amount during operation was up to 800～1 600 mL.Three of whom had post-operative complications: 1 with biliary fistula,1 with intestinal fistula and 1 with upper gastrointestinal bleeding.The other patient died of multi-organ dysfunction in preoperative period.Conclusion To the patients of biliary tract re-operation accompanied with hepatocirrhosis and portal hypertension,surgical operation will get good results if the assessment of relevant pre-operative issues are enhanced and the appropriate treatments are executed.Child-Pugh classification is not appropriate to assess the patients of biliary tract re-operation accompanied with hepatocirrhosis and portal hypertension.