肝外型门静脉高压症的外科治疗

目的 探讨肝外型门静脉高压症的诊断和治疗方法。方法 自１９９３年１月￣１９９９年９月,本所收治肝外型门静脉高压症４１例。男１８例,女２３例,年龄８￣５８岁,平均２４．６岁,病因为门静脉血栓形成３４例,腹腔内脏动静脉瘘４例,门静脉终末支纤维化２例,肝动脉瘤压迫门静脉１例。根据不同病变分别施行肠－腔静脉分流,脾－肾静脉分流,经导管溶栓及栓塞,动静脉瘘切除等治疗。结果 术后２例死亡,并发肝脓肿和肠坏死各

Surgical management of extrahepatic portal hypertension

Objective To explore the diagnosis and treatment of extrahpatic portal hypertension(EPH). Method From January 1993 to September 1999, 41 patients with EPH were treated in General Post Telecom Hospital. In this series, there were 19 males and 23 females. Age ranged from 8 to 58 with a mean of 24.6 years. Of them, 34 cases belonged to thrombosis of portal vein, 4 visceral artriovenous fistulas(AVF), 2 terminal portal fibrosis, and 1 portal vein compression by hepatic aneurysm. According to different lesions, mesocaval venous shunt, splenorenal venous shunt, removal of AVF, thrombolysis or embolization by catheter were carried out. Result 2 patients died. Complications included hepatic abscess and intestinal necrosis each in one ease. The other patients obtained satisfactory results. Thirty one cases(79.5%) were followed up for 3 months to 6 years, no recurrence was found. Conclusions Patients with EPH usually have normal liver morphology and function, and can be effectively treated by proper means with fairly good outcome. Preoperative correct diagnosis is of paramount importance.