Analysis of Operation and Prognosis of Budd-Chiari Syndrome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 MENGQing-yi , WANGRui-hua , LIUZhao-xuan , LIBo , ZHANGJun-yu ,  WUDing

Department of Vascular Surgery, Affiliated Jinan Central Hospital of Shandong University, Jinan 250013, Shandong Province, China;

Corresponding?author：

WUDing, Email: 49716282@qq.com

Keywords：

Budd-Chiari syndrome; Surgical treatment; Interventional surgery; Hepatic vein; Inferior vena cava

DOI：

10.7507/1007-9424.20140353

Video：

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Objective To investigate the basic operation and treatment experiences of the surgical treatment of Budd-Chiari syndrome (BCS). Methods Clinical data of 1 024 cases of BCS who received surgical treatment in our hospital from April 1994 to December 2013 were collected and analyzed. Results There were 1 024 cases in our study, 116 cases of them underwent surgery, 908 cases of them underwent interventional surgery; 265 cases underwent inferior vena cava (IVC) balloon dilatation, 464 cases underwent IVC balloon dilatation and stenting, 97 cases underwent open surgery of hepatic vein (HV), 52 cases underwent right atrium femoral vein combined membrane rupture balloon dilation stent, 7 cases underwent caval shunt, 20 cases underwent radical surgery, 45 cases underwent IVC-right atrium bypass, 6 cases underwent intestinal cavity-real shunt, 9 cases underwent intestinal cavity-neck combined shunt, 30 cases underwent transjugular intrahepatic portosystemic shunt, 29 cases underwent intestinal-line real shunt. There were 902 cases were followed-up for 1 day-19 years (13 years on average), and the application of many kinds of operation strictly and flexibly brought satisfactory results for cases of BCS. Conclusions The diagnosis and classification of BCS will help us to make safe, effective, and appropriate treatment plan. In addition, we must use color Doppler ultrasound to observe the pathological changes of the situation, in this way we can have a clear goal in the treatment process.

Citation： MENGQing-yi, WANGRui-hua, LIUZhao-xuan, LIBo, ZHANGJun-yu, WUDing. Analysis of Operation and Prognosis of Budd-Chiari Syndrome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(12): 1482-1486. doi: 10.7507/1007-9424.20140353 Copy

1.	Okuda K.Membranous obstruction of the inferior vena cava (obli-terative hepatocavopathy, Okuda)[J].J Gastroenterol Hepatol, 2001, 16(11):1179-1183.
2.	Xu PQ, Ma XX, Ye XX, et al.Surgical treatment of 1360 cases of Budd-Chiari syndrome:20-year experience[J].Hepatobiliary Pancreat Dis Int, 2004, 3(3):391-394.
3.	汪忠鎬.汪忠鎬血管外科學[M].杭州:浙江科學技術出版社, 2010:628-652.
4.	Lee BB, Villavicencio L, Kim YW, et al.Primary Budd-Chiari syndrome:outcome of endovascular management for suprahepatic venous obstruction[J].J Vasc Surg, 2006, 43(1):101-108.
5.	汪忠鎬, 李春民, 谷涌泉, 等.疑難重癥或介入后復發布-加綜合征的治療[J].中華外科雜志, 2008, 46(15):1149-1152.
6.	Wang ZG, Zhang FJ, Yi MQ, et al.Evolution of management for Budd-Chiari syndrome:a team's view from 2564 patients[J].ANZ J Surg, 2005, 75(1-2):55-63.
7.	孟慶義, 馬波民, 張帆.布加綜合征650例診治體會[J].臨床和實驗醫學雜志, 2003, 2(4):209-213.
8.	孟慶義.布加綜合征介入治療與外科手術:外科醫師的選擇[J].介入放射學雜志, 2008, 17(4):299-302.
9.	Meng QY, Sun NF, Wang JX, et al.Endovascular treatment of Budd-Chiari syndrome[J].Chin Med J (Engl), 2011, 124(20):3289-3292.
10.	Eguchi S, Takeuchi Y, Asano K.Successful ballon membranotory obstruction of the hepatic portion of the inferior vena cava[J].Surgery, 1974, 76(5):837-840.
11.	Charnsangavej C, Carrasco CH, Wallace S, et al.Stenosis of the vena cava:preliminary assessment of treatment with expandable metalic stents[J].Radiology, 1986, 161(2):295-298.
12.	Furui S, Sawada S, Irie T, et al.Hepatic inferior vena cava obstru-ction:treatment of two types with Gianturco expandable metallic stents[J].Radiology, 1990, 176(3):665-670.
13.	崔進國, 馮艷皎, 馮子壇, 等.節段性狹窄閉塞布加綜合征的介入治療[J].中華外科雜志, 1996, 34(7):400-402.
14.	Xu K, Feng B, Zhong H, et al.Clinical application of interventional techniques in the treatment of Budd-Chiari syndrome[J].Chin Med J, 2003, 116(4):609-615.
15.	Sharma S, Texeira A, Texeira P, et al.Pharmacological thrombolysis in Budd Chiari syndrome:a single centre experience and review of the literature[J].J Hepatol, 2004, 40(1):172-180.
16.	Zhang CQ, Fu LN, Xu L, et al.Long-term effect of stent placement in 115 patients with Budd-Chiari syndrome[J].World J Gastroenterol, 2003, 9(11):2587-2591.
17.	顧玉明, 祖茂衡, 徐浩, 等.500例Budd-Chiari綜合征介入治療并發癥分析[J].中華放射學雜志, 2003, 37(12):1083-1086.
18.	項軍, 朱耀青, 王巖, 等.不同球囊導管治療下腔靜脈阻塞的回顧性分析[J].徐州醫學院學報, 2004, 24(1):22-25.
19.	Ding PX, Han XW, Wu G, et al.Outcome of a retrieval stent filter and 30 mm balloon dilator for patients with Budd-Chiari synd-rome and chronic inferior vena cava thrombosis:a prospective pilot study[J].Clin Radiol, 2010, 65(8):629-635.
20.	徐克, 周玉斌, 王愛林, 等.國產ZQL型可回收式腔靜脈濾器的初步臨床應用與觀察[J].中華放射學雜志, 2003, 37(3):228-231.
21.	徐忠立.巴德-恰瑞綜合征[M].鄭州:河南醫科大學出版社, 2001:249-262.
22.	汪忠鎬, 王仕華, 吳繼東, 等.球囊導管擴張和腔內支架置放法治療布加綜合征[J].中華醫學雜志, 1995, 75(2):97-99.
23.	韓新巍, 李永東.布-加綜合征介入治療技術操作規范的幾點建議[J].介入放射學雜志, 2002, 11(4):316-318.
24.	祖茂衡, 張慶橋, 顧玉明, 等.血管內支架在布-加綜合征遠期療效再評價[J].當代醫學:中國介入放射學, 2008, 2(3):206-208.
25.	Mammen T, Keshava S, Eapen CE, et al.Intrahepatic collateral recanalization in symptomatic Budd-Chiari syndrome:a single-center experience[J].J Vasc Interv Radiol, 2010, 21(7):1119-1124.
26.	孫俊凱, 李欣, 鄭傳勝, 等.第二肝門重建術治療肝靜脈阻塞型Budd-Chiari綜合征[J].臨床放射學雜志, 2009, 28(10):1435-1439.

1. Okuda K.Membranous obstruction of the inferior vena cava (obli-terative hepatocavopathy, Okuda)[J].J Gastroenterol Hepatol, 2001, 16(11):1179-1183.
2. Xu PQ, Ma XX, Ye XX, et al.Surgical treatment of 1360 cases of Budd-Chiari syndrome:20-year experience[J].Hepatobiliary Pancreat Dis Int, 2004, 3(3):391-394.
3. 汪忠鎬.汪忠鎬血管外科學[M].杭州:浙江科學技術出版社, 2010:628-652.
4. Lee BB, Villavicencio L, Kim YW, et al.Primary Budd-Chiari syndrome:outcome of endovascular management for suprahepatic venous obstruction[J].J Vasc Surg, 2006, 43(1):101-108.
5. 汪忠鎬, 李春民, 谷涌泉, 等.疑難重癥或介入后復發布-加綜合征的治療[J].中華外科雜志, 2008, 46(15):1149-1152.
6. Wang ZG, Zhang FJ, Yi MQ, et al.Evolution of management for Budd-Chiari syndrome:a team's view from 2564 patients[J].ANZ J Surg, 2005, 75(1-2):55-63.
7. 孟慶義, 馬波民, 張帆.布加綜合征650例診治體會[J].臨床和實驗醫學雜志, 2003, 2(4):209-213.
8. 孟慶義.布加綜合征介入治療與外科手術:外科醫師的選擇[J].介入放射學雜志, 2008, 17(4):299-302.
9. Meng QY, Sun NF, Wang JX, et al.Endovascular treatment of Budd-Chiari syndrome[J].Chin Med J (Engl), 2011, 124(20):3289-3292.
10. Eguchi S, Takeuchi Y, Asano K.Successful ballon membranotory obstruction of the hepatic portion of the inferior vena cava[J].Surgery, 1974, 76(5):837-840.
11. Charnsangavej C, Carrasco CH, Wallace S, et al.Stenosis of the vena cava:preliminary assessment of treatment with expandable metalic stents[J].Radiology, 1986, 161(2):295-298.
12. Furui S, Sawada S, Irie T, et al.Hepatic inferior vena cava obstru-ction:treatment of two types with Gianturco expandable metallic stents[J].Radiology, 1990, 176(3):665-670.
13. 崔進國, 馮艷皎, 馮子壇, 等.節段性狹窄閉塞布加綜合征的介入治療[J].中華外科雜志, 1996, 34(7):400-402.
14. Xu K, Feng B, Zhong H, et al.Clinical application of interventional techniques in the treatment of Budd-Chiari syndrome[J].Chin Med J, 2003, 116(4):609-615.
15. Sharma S, Texeira A, Texeira P, et al.Pharmacological thrombolysis in Budd Chiari syndrome:a single centre experience and review of the literature[J].J Hepatol, 2004, 40(1):172-180.
16. Zhang CQ, Fu LN, Xu L, et al.Long-term effect of stent placement in 115 patients with Budd-Chiari syndrome[J].World J Gastroenterol, 2003, 9(11):2587-2591.
17. 顧玉明, 祖茂衡, 徐浩, 等.500例Budd-Chiari綜合征介入治療并發癥分析[J].中華放射學雜志, 2003, 37(12):1083-1086.
18. 項軍, 朱耀青, 王巖, 等.不同球囊導管治療下腔靜脈阻塞的回顧性分析[J].徐州醫學院學報, 2004, 24(1):22-25.
19. Ding PX, Han XW, Wu G, et al.Outcome of a retrieval stent filter and 30 mm balloon dilator for patients with Budd-Chiari synd-rome and chronic inferior vena cava thrombosis:a prospective pilot study[J].Clin Radiol, 2010, 65(8):629-635.
20. 徐克, 周玉斌, 王愛林, 等.國產ZQL型可回收式腔靜脈濾器的初步臨床應用與觀察[J].中華放射學雜志, 2003, 37(3):228-231.
21. 徐忠立.巴德-恰瑞綜合征[M].鄭州:河南醫科大學出版社, 2001:249-262.
22. 汪忠鎬, 王仕華, 吳繼東, 等.球囊導管擴張和腔內支架置放法治療布加綜合征[J].中華醫學雜志, 1995, 75(2):97-99.
23. 韓新巍, 李永東.布-加綜合征介入治療技術操作規范的幾點建議[J].介入放射學雜志, 2002, 11(4):316-318.
24. 祖茂衡, 張慶橋, 顧玉明, 等.血管內支架在布-加綜合征遠期療效再評價[J].當代醫學:中國介入放射學, 2008, 2(3):206-208.
25. Mammen T, Keshava S, Eapen CE, et al.Intrahepatic collateral recanalization in symptomatic Budd-Chiari syndrome:a single-center experience[J].J Vasc Interv Radiol, 2010, 21(7):1119-1124.
26. 孫俊凱, 李欣, 鄭傳勝, 等.第二肝門重建術治療肝靜脈阻塞型Budd-Chiari綜合征[J].臨床放射學雜志, 2009, 28(10):1435-1439.

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Analysis of Operation and Prognosis of Budd-Chiari Syndrome

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