门脉高压症上消化道大出血急诊手术治疗体会

目的探讨门脉高压症食管胃底静脉曲张破裂出血急诊手术时机和疗效。方法2002年1月~2007年4月48例肝硬化门脉高压症上消化道大出血患者行急诊选择性贲门周围血管离断,其中18例加行改良Sugiura术。结果45例获随访,平均18(3~24)个月,无术后死亡,无吻合口瘘和肝性脑病,无术后再出血的发生。结论选择性贲门周围血管离断和条件允许情况下的改良Sugiura术能有效地治疗门脉高压症食管胃底静脉曲张破裂出血,降低术后再出血率和并发症发生率。

Emergent Surgical Treatment for Upper Gastrointestinal Bleeding duo to Portal Hypertension

Objective To discuss the opportunity and effect of emergent surgical intervention for portal hypertension with esophageal gastric-fundus variceal bleeding(EGVB).Methods 48 cirrhosis portal hypertension patients with EGVB admitted from Jan.2002 to Apr. 2007 were analyzed retrospectively.All cases underwent selective pericardial devascularization,of 18 plus modified Sugiura operation.Results 45 patients were followed up from 3 to 24 months.No operative death,anastomotic fistula,hepatic encephalopathy and rebleeding occurred.Conclusion Selective pericardial devascularization and suitable modified Sugiura is an effective therapy with low incidence of rebleeding and complication.