Splenocaval versus mesocaval shunt with artificial vascular graft for the treatment of Budd-Chiari syndrome.
BACKGROUND
Budd-Chiari syndrome (B-CS) is a disease with a poor prognosis, and the results of medication are not satisfactory. Surgical treatments are widely used to depress portal hypertension and hypertension of the inferior vena cava. Splenocaval shunt is usually applied to treat intrahepatic portal hypertension, but we used this method to treat patients with B-CS successfully.


METHODS
The clinical data of 72 B-CS patients (type II), including 26 patients treated with splenocaval shunt (splenocaval group) and 46 patients with mesocaval C-shape shunt (mesocaval group) were analyzed retrospectively.


RESULTS
The platelet count of the splenocaval group increased significantly after operation (P<0.05). Free portal pressure (FPP) significantly decreased in both groups after operation (P<0.05), but no significant difference was seen between the two groups (P>0.05). Twenty patients in the splenocaval group and 36 in the mesocaval group were followed up for 6 months to 3.5 years, showing the effective rates of 90.0% and 91.7% respectively in the two groups. The occurrence of hepatic encephalopathy was 5.0% and 5.6% respectively in both groups, but there was no recurrent hemorrhage.


CONCLUSIONS
Splenocaval shunt can effectively control B-CS, decrease FPP, prevent upper gastrointestinal hemorrhage, and eradicate hypersplenia. Its efficacy is similar to that of mesocaval shunt in treatment of B-CS.
Dang
Xiao-Wei
XW
Deparment of General Surgery, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China. dangxw1001@zzu.edu.cn
Xu
Pei-Qin
PQ
Ma
Xiu-Xian
XX
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000792:Angiography; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical / Q000379:methods*; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D013164:Splenorenal Shunt, Surgical / Q000379:methods*; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology; D014682:Vena Cava, Inferior / Q000601:surgery*