title: Radical surgery for Budd-Chiari syndrome. Direct excision and repair for obstruction of the vena cava (Budd-Chiari syndrome) under hepatic vascular exclusion using a centrifugal pump.
abstract: OBJECTIVE
  To attempt to reduce the incidence of hepatic and cardiac failure after radical surgery for the Budd-Chiari syndrome.
  
  
  METHODS
  Retrospective case study.
  
  
  METHODS
  University hospital, Japan
  
  
  METHODS
  Three patients with obstruction of the vena cava (Budd-Chiari syndrome) by a thick membrane, thrombus, and a long stenosis, respectively.
  
  
  METHODS
  Direct excision and repair by patch dilatation under hepatic vascular exclusion using a Biomedicus centrifugal pump.
  
  
  RESULTS
  Hepatic vascular exclusion provides good visibility and enables accurate assessment of the obstruction, proper treatment, and relatively little blood loss. There were no complications, particularly liver failure or heart failure, and the inferior vena cava stayed patent in all cases. Liver function was improved in all three patients.
  
  
  CONCLUSIONS
  This technique is safe and reliable for removal of obstruction of the inferior vena cava (Budd-Chiari syndrome).
authors.affiliation: Third Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takano
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: H
authors.initials: H
authors.lastname: Ohishi
authors.forename: S
authors.initials: S
authors.lastname: Kono
authors.forename: S
authors.initials: S
authors.lastname: Kawakami
authors.forename: S
authors.initials: S
authors.lastname: Iwai
mesh_terms: D000818:Animals; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D005112:Extracorporeal Circulation / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010496:Pericardium / Q000637:transplantation; D011859:Radiography; D013536:Suture Techniques; D013552:Swine; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery*