门静脉高压症120例手术治疗体会

目的探讨改良的Sugiura手术在治疗门静脉高压症上消化道大出血中的运用。方法自2001年7月至2007年12月普外科收治门静脉高压症上消化道出血120例，58例急诊行改良的Sugiura手术，47例急诊行贲门周围血管离断术，延期15例行改良的Sugiura手术。结果105例急诊手术者术后均立即获得确切的止血效果；改良的Sugiura手术组无吻合口漏及吻合口狭窄发生，术后并发症轻微；术后两组病人门静脉高压性胃病发生程度差异无统计学意义。结论改良的Sugiura手术并未增加手术风险，近期、远期疗效满意，是治疗门静脉高压症上消化道大出血的较佳方法。

Surgical experience of the upper gastrointestinal hematorrhea caused by portal hypertention in 120 cases

Objective To evaluate the effect of modified Sugiura procedure in the treatment of acute upper gastrointestinal hematorrhea caused by portal hypertention. Methods From Jul. 2001 to Dec. 2007, there were 120 patients suffering from acute upper gastrointestinal hematorrhea caused by portal hypertention secondary to post-hepatitis liver cirrhosis. Among them 105 cases were subjected to emergency surgery. The results of modified Sugiura procedure performed on 58 patients were analyzed. Results Bleeding was terminated in all of the 105 cases undergoing emergency surgery with modified Sugiura procedure or traditional extensive esophagogastric devascularization. No anastomotic leakage or stricture was observed in the modified Sugiura procedure group. The post-operative complications were acceptable. The hepatic function of the survivals was in stable situation during the follow-up period. Conclusion The modified Sugiura procedure is satisfactory with a low complication rate, and low bleeding recurrence in the treatment of acute hematorrhea caused by portal hypertention.