[Management of difficult, severe and recurrent Budd-Chiari syndrome].
OBJECTIVE
To investigate the management of complicated, severe or recurrent Budd-Chiari syndrome.


METHODS
From February 2004 to August 2007, 28 patients with complicated, severe or recurrent Budd-Chiari syndrome were treated. In this series, 16 patients relapsed after treated with percutaneous transluminal angioplasty or stent deployment, 2 cases relapsed after surgery; and the other 10 were under severe conditions and hard to treat, including malignancy of the inferior vena cava and right atrium. Meso-cavo-atrial shunt was carried out in 10 cases, meso-cavo-jugular shunt in 6 (capitis medusa was used in one case), cavoatrial shunt in 2 and cavo-jugular shunt in 1, mesocaval shunt in 2, and radical or extended radical correction in 7.


RESULTS
One patient (3.6%) died in 24 hours after operation. Graft infection occurred in 1 case. Excellent, good, fair, poor and death rate were 22.2%, 55.5%, 14.8%, 3.7% and 3.7%, respectively, the overall effective rate was 92.5%.


CONCLUSIONS
To select personalized treatment according to the disease status brings hopes to difficult, severe, recurrent Budd-Chiari syndrome.
Wang
Zhong-gao
ZG
Department of Vascular Surgery, Xuanwu Hospital, the Capital Medical University, Beijing 100053, China. zhonggaowang@yahoo.com
Li
Chun-min
CM
Gu
Yong-quan
YQ
Yu
Heng-xi
HX
Chen
Bing
B
Guo
Lian-rui
LR
Li
Xue-feng
XF
Cui
Shi-jun
SJ
Li
Zhen
Z
D000293:Adolescent; D000328:Adult; D019917:Blood Vessel Prosthesis Implantation; D006502:Budd-Chiari Syndrome / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome