SURGICAL RECONSTRUCTION OF BUDD-CHIARI SYNDROME

概要

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Four patients with idiopathic Budd-Chiari syndrome with occlusion of the hepatic veins and significant obstruction of hepatic segment of the inferior vena cava were presented. All but one patients were treated with transatrial bimanual finger fraction method and trans-infrahepatic inferior vena cava thromboendoarterectomy. For postoperative restenosis or reocclusion, percutaneous transluminal angioplasty was applied. All patients required a total of two four times of angioplasties during follow-up period ranged from 24 to 79 months. All three patients redeveloped swelling and pigmentation by venous congestion of their legs and showed remarkable improvement of endoscopic findings of esophageal varix and ICG liver function examination. No serious complication was reported. <BR>In conclusion, this operation is a safe method for Budd-Chiari syndrome, even in the case of long segment obstruction; percutaneous transluminal angioplasty is a safe and effective mode of therapy in the management of postoperative restenosis of the inferior vena cava; and adjoining successful angioplasty is accompanied by long term dramatic regression of clinical symptoms.
日本臨床外科学会の論文