经腹路布一加氏综合征根治术─—附1例报告

本文报告经腹路行布一加氏综合征根治性手术１例。手术在常温全麻下进行，取双肋缘下“人”字形切口进腹，经充分游离肝上、下段下腔静脉后，显露肝右、中、左静脉，将复盖于肝静脉前方的肝组织适当游离，以充分显露肝静脉入口平面之下腔静脉狭窄部。常温下阻断全肝血流后，直视下切开下腔静脉狭窄部，切除一约４ｍｍ厚之环形膈膜及疤痕组织，取自体大隐静脉补片成形。术终时下腔静脉压由５．８８ｋＰａ降至２．７５ｋＰａ。全肝血流阻断时间为３８分钟。术后恢复顺利。术后１８天下腔静脉造影示原梗阻部消失；彩色多普勒检查示下腔静脉血流通畅，肝静脉及门静脉口径均较术前缩小。

A RADICAL OPERATION FOR THE BUDDCHIARI SYNDROMEVIA ABDOMINAL APPROACHREPORT A CASE

his paper reports one patient with Budd-Chiari Syndrome who underwent aradical operation via abdominal approach. The operation was performed undergeneral anasthesia. After dissection of the perihepatic ligments, the supra-andinfrahepatic segments of inferior vena cava, and the liver parenchyma which cov-ered the front of the hepatic veins, the stenosed segment of IVC were demon-strated clearly. Under total hepatic vascular occlusion, the stenosed segment ofIVC was opened, and a circular fibrous diaphragm, about 4rnrn thick, was cutunder direct vision , then an autosapheneous vein patch was implanted to performan angioplasty. The pressure of IVC significantly fell from 5. 88 kpa to 2.75kpa. The time of normothernuc total hepatic vessel occlusion was 38 minutes.The postoperative course was uneventful. By the postoperative day, a IVC an-giography showed that the stenosis of the vessel disappeared.