肝圆韧带桥式分流联合断流术治疗门静脉高压症

目的评价肝圆韧带桥式分流联合断流术治疗门静脉高压症的临床效果.方法对4例应用肝圆韧带桥式分流联合断流术治疗的门静脉高压症病人的手术情况、手术效果、随访结果进行回顾性分析.结果4例病人中,3例接受了肝圆韧带桥式肠腔分流联合断流术,1例接受肝圆韧带桥式脾肾分流术联合断流术.术中利用肝圆韧带长度4～6 cm,平均5 cm.分流后门静脉压力平均下降7.6 cm H2O,本组无手术死亡及严重手术并发症.随访肝功能均有明显改善,食管胃底静脉曲张均消失,彩超检查肝圆韧带桥无堵塞,吻合口通畅,无再出血.结论肝圆韧带桥式分流联合断流术是一种新的有效的治疗门静脉高压症的手术方式.

Ligmentum teres hepatis-bridged shunt combined with devascularization for treatment of portal hypertension

Objective To Study the feasibility and clinical effect on ligmentum teres hepatis-brdiged shunt combined with devascularization for treatment of portal hypertension.Methods The data of 4 cases with portal hypertension who had been performed on ligmentum teres hepatis-bridged shunt combined with devascularization,was analyzed retrospectively.Results 3 of 4 patients had been performed on ligmentam teres hepatis-bridged mesocaval shunt combined with devascularization,1 of ligmentam teres hepatis-bridged splenorenal shunt combined with devascularization.The graft length used during operation was 4 to 6 cm,the average length was 5 cm.The free portal pressure(FPP) dropped averagely 7.6 cm H_2O after shunt operations.All of the patients had no death and serious operation complications.The follow-up showed that the esophageal varicosis disappeared,no hemorrhage recurred,the liver function was improved,and the anastomosis of graft kept unblocked.Conclusion The ligment teres hapetis-briged shunt combined with devascularization is a new effective surgical method for treating portal hypertension