经左颈静脉肝内门腔静脉支架分流术（附12例报告）

为解决肝硬变门脉高压患者在经颈静脉肝内门腔静脉支架分流术中右颈静脉窄或闭的难题，我们做了经左颈静脉途径完成肝内门腔分流术的尝试。自１９９３年７月至１９９５年８月，共１７８例ＴＩＰＳＳ操作中发现１２例右颈静脉狭窄或闭塞。其方法为经左颈内静脉穿刺、插管入路。

Left Transjugular Approach for Percutaneous Intrahepatic Portosystemic Stent Shunt:Report of 12 Cases

This paper aimed at introducing that left transjugular approach for percutaneous intrahepatic portosystemic stent shunt has been attempted when the right jugular vein was found to be thrombosed or occluded.Materials and Methods:From July 1993 to August 1995,178 cirrhotic patients were undergone TIPSS for variceal bleeding.In 12 of 178 patients,the right jugular vein was found to be thrombosed or occluded.The left transjugular approach was therefore tried in these 12 patients.Results:Although some obstacles have been met,but were all successfully overcome.The left thansjugular approach has been successfully carried out in all the 12 patients without complication.Conclusion:The usual transjugular portosystemic stent shunt may fail,due to right jugular vein was thrombosed or occluded.Our results indicate that left transjugular approach for TIPSS is a safe and effective method in the patient with right jugular vein thrombosed or occluded.