Diagnosis and management of severe Budd-Chiari syndrome.
OBJECTIVE
To assess the diagnostic standards and treatment of severe Budd-Chiari syndrome (BCS).


METHODS
The clinical data of 126 patients with severe BCS treated from November 1994 to June 2001 at our hospital were retrospectively analyzed. Percutaneous transhepatic recanalization and dilation and/or stent placement of the main hepatic vein was performed in 10 patients. Mesocaval C type shunt with artificial graft was performed in 68 patients, splenojugular shunt in 33, mesojuglar shunt in 1, and mesocaval shunt or improved splenopneumopexy after percutaneous intraluminal angioplasty and stent placement of the inferior vena cava in 14.


RESULTS
Six patients died during perioperation. In 120 patients followed up for 6 months to 7 years, 89 had excellent results and 31 good results.


CONCLUSIONS
Diagnostic standards of severe BCS are suggested. Proper treatment should be used according to the pathological changes of the inferior vena cava and main hepatic veins.
Xu
Pei-Qin
PQ
Department of General Surgery, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China. vl_institute1086@163.com
Dang
Xiao-Wei
XW
D000293:Adolescent; D000328:Adult; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods*; D006502:Budd-Chiari Syndrome / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical / Q000379:methods*; D011183:Postoperative Complications / Q000401:mortality; D011300:Preoperative Care; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome