Improvement in esophageal varices and liver histology postoperatively in Budd-Chiari syndrome.
BACKGROUND
In the past 17 years, 32 patients with Budd-Chiari syndrome were treated by reconstruction of the occluded inferior vena cava and reopening of the hepatic veins under femoro-femoral normothermic extracorporeal partial bypass. The mean follow-up was 8 years (range, 1.5 to 17 years).


METHODS
To evaluate the benefits of our operative procedure, we compared the preoperative, early postoperative, and late postoperative endoscopic appearance of the esophageal varices and the histologic findings of the liver tissue obtained intraoperatively and at a later date.


RESULTS
The esophageal varices found preoperatively in 29 patients (90.6%) had disappeared in 7 patients by the time of discharge, and in 2 patients they disappeared 4 to 7 years after surgery. In the remaining 20 patients, the grade of the esophageal varices was reduced markedly. Histologic examination of the liver showed cirrhosis in 22 patients, fibrosis in 9 patients, and severe congestion in 1 patient. Inspection of the liver in the late postoperative period (in 10 patients) showed improvement in centrilobular congestion and no increase in interlobular fibrosis.


CONCLUSIONS
Gradual and steady improvement of esophageal varices and hepatic fibrosis can be achieved after our operative procedure.
Kuniyoshi
Y
Y
Second Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
Koja
K
K
Akasaki
M
M
Miyagi
K
K
Shimoji
M
M
Kudaka
M
M
Uezu
T
T
D000328:Adult; D000368:Aged; D006502:Budd-Chiari Syndrome / Q000601:surgery*; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D004945:Esophagoscopy; D005112:Extracorporeal Circulation; D005260:Female; D005263:Femoral Artery; D005268:Femoral Vein; D005500:Follow-Up Studies; D006503:Hepatic Veins / Q000473:pathology / Q000601:surgery; D006801:Humans; D008099:Liver / Q000473:pathology; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D014654:Vascular Patency; D014682:Vena Cava, Inferior / Q000601:surgery