Application of Modified Sugiura Procedure with Cardia Transection in Treatment of Recurrent Portal Hypertension with Upper Gastrointestinal Bleeding_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

1. Department of General Surgery, The Second People's Hospital of Yichang, The Second People's Hospital of Three Gorges University, Yichang 443000, Hubei Province, China;
2. Department of General Surgery, The Zigui County People's Hospital, Zigui 443600, Hubei Province, China;

Corresponding?author：

Keywords：

Portal hypertension; Modified Sugiura prosedure; Cardia transection; Clinical effect

DOI：

10.7507/1007-9424.20160278

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Objective To evaluate clinical efficacy of the modified Sugiura procedure with cardia transection in treatment of recurrent portal hypertension with upper gastrointestinal bleeding. Methods From January 2007 to January 2015, there were 28 cases of recurrent portal hypertension with upper gastrointestinal bleeding were treated by the modified Sugiura procedure with cardia transection in The Second People's Hospital of Yichang and The Zigui County People's Hospital, collecting the clinical data of them and then summarizing the therapeutic effect. Results All cases underwent surgery successfully with no operative death. The operative time was 120-300 minutes with an average of 160 minutes. About surgical blood loss was 100-500 mL, with an average of 210 mL. Two cases suffered from postoperative gastrointestinal bleeding, 6 cases suffered from postoperative gastric dysfunction, and no one suffered from anastomotic leakage, anastomotic stenosis, and portal vein thrombosis. Three cases died in reason of liver failure and hepatic coma. There were 24 cases were followed up for 6-60 months, with the median of 33 months. No recurrence of gastrointestinal bleeding happened during the follow-up period. Sixteen cases underwent gastroscopy in 6 months after surgery, according to the results, the clinical effect was fine. For grade of varicose veinsm, there were 14 cases of grade GⅠ and 2 cases of grade GⅡ. For shape of varicose veins, there were 11 cases of grade F1 and 5 cases of grade F2. Conclusion The modified Sugiura procedure with cardia transection is a safe and thorough operation for recurrent portal hypertension with bleeding.

Citation： GONG Jiang-bo, MEI Chang-qing. Application of Modified Sugiura Procedure with Cardia Transection in Treatment of Recurrent Portal Hypertension with Upper Gastrointestinal Bleeding. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(9): 1089-1092. doi: 10.7507/1007-9424.20160278 Copy

1.	劉洪沨, 李小毅, 劉躍武, 等.門靜脈高壓癥術后消化道再出血的臨床研究.中國普外基礎與臨床雜志, 2010, 17(8):820-823.
2.	Wu YK, Wang YH, Tsai CH, et al. Modified hassab procedure in the management of bleeding esophageal varices-a two-year experience. Hepatogastroenterology, 2002, 49(43):205-207.
3.	Kitano S, Terblanche J, Kahn D, et al. Venous anatomy of the lower oesophagus in portal hypertension:practical implications. Br J Surg, 1986, 73(7):525-531.
4.	王文靜, 曹國軍, 胡青鋼.門靜脈高壓癥行斷流術后再出血43例診治體會.中國實用外科雜志, 2015, 35(12):1321-1324.
5.	Garcia-Tsao G, Bosch J. Management of varices and variceal hemorrhage in cirrhosis. N Engl J Med, 2010, 362(9):823-832.
6.	中華消化內鏡學會.食管胃底靜脈曲張內鏡下診斷和治療規范試行方案.中華消化內鏡雜志, 2000, 17(4):198-199.
7.	Yoshida H, Mamada Y, Taniai N, et al. New methods for the management of gastric varices. World J Gastroenterol, 2006, 12(37):5926-5931.
8.	吳志勇, 陳煒.肝硬化門靜脈高壓癥外科治療程序.中國實用外科雜志, 2011, 31(1):39-43.
9.	許永慶, 戴朝六, 卜獻民, 等.門靜脈高壓癥上消化道出血行急診斷流術的治療體會.中國普外基礎與臨床雜志, 2013, 20(1):33-36.
10.	陳亞晗.斷流術與分流術在門靜脈高壓治療的比較.安徽醫藥, 2013, 17(8):1336-1337.
11.	胡建平, 陳軍, 吳松, 等.門脈高壓癥急診改良Sugiura手術體會.肝膽外科雜志, 2010, 18(4):280-283.
12.	武林楓, 劉連新, 趙金鵬, 等.改良Sugiura手術和賁門周圍血管離斷術治療門靜脈高壓癥的療效比較.中華普通外科雜志, 2005, 20(1):24-26.
13.	張賀云, 徐鋆耀, 陳亞進, 等.賁門周圍血管離斷術與改良Sugiura手術治療門靜脈高壓癥的療效比較.中華肝膽外科雜志, 2010, 16(8):586-589.
14.	劉思達, 黎一鳴, 吉鴻, 等.賁門周圍血管離斷術治療門靜脈高壓癥療效的Meta分析.中國普外基礎與臨床雜志, 2014, 21(1):69-75.
15.	中華醫學會外科學分會門靜脈高壓癥學組.肝硬化門靜脈高壓癥食管胃底靜脈曲張破裂出血診治專家共識(2015).中國實用外科雜志, 2015, 35(10):1086-1090.
16.	冷希圣.門靜脈高壓癥斷流手術的爭論.現代外科雜志, 2008, 20(7):497-499.
17.	林折輝, 羅開國, 王曉山, 等.改良Sugiura術橫斷食管與橫斷賁門的療效對比.肝膽外科雜志, 2015, 23(3):225-228.
18.	曹亞娟, 謝敏, 包善華, 等.門靜脈高壓癥消化道出血的臨床特點分析.肝膽外科雜志, 2009, 17(6):415-418.
19.	楊鎮.門靜脈高壓癥的最新外科治療.濟南:山東科學技術出版社, 2005:425-430.
20.	楊鎮.選擇性賁門周圍血管離斷術的發展與手術技巧.中國實用外科雜志, 2009, 29(5):450-451.
21.	冷希圣.肝移植時代門靜脈高壓癥治療策略.中國實用外科雜志, 2009, 19(5):373-376.
22.	任德發, 牛曉泉, 鄭剛, 等.非選擇性與選擇性賁門周圍血管離斷術治療門靜脈高壓癥并上消化道出血86例分析.臨床外科雜志, 2013, 21(4):271-273.
23.	吳性江, 曹建民, 吳學豪, 等.門靜脈高壓癥患者冠狀靜脈解剖變異及臨床意義.中華外科雜志, 2000, 38(2):89-91.
24.	李傳福, 萬旭宏, 陳慶學.腸道細菌易位及炎癥反應綜合征.中國煤炭工業醫學雜志, 2009, 12(9):1479-1480.
25.	姜彤, 趙玉斌.空腸營養置管方法研究進展.解放軍醫藥雜志, 2011, 23(5):94-96.

1. 劉洪沨, 李小毅, 劉躍武, 等.門靜脈高壓癥術后消化道再出血的臨床研究.中國普外基礎與臨床雜志, 2010, 17(8):820-823.
2. Wu YK, Wang YH, Tsai CH, et al. Modified hassab procedure in the management of bleeding esophageal varices-a two-year experience. Hepatogastroenterology, 2002, 49(43):205-207.
3. Kitano S, Terblanche J, Kahn D, et al. Venous anatomy of the lower oesophagus in portal hypertension:practical implications. Br J Surg, 1986, 73(7):525-531.
4. 王文靜, 曹國軍, 胡青鋼.門靜脈高壓癥行斷流術后再出血43例診治體會.中國實用外科雜志, 2015, 35(12):1321-1324.
5. Garcia-Tsao G, Bosch J. Management of varices and variceal hemorrhage in cirrhosis. N Engl J Med, 2010, 362(9):823-832.
6. 中華消化內鏡學會.食管胃底靜脈曲張內鏡下診斷和治療規范試行方案.中華消化內鏡雜志, 2000, 17(4):198-199.
7. Yoshida H, Mamada Y, Taniai N, et al. New methods for the management of gastric varices. World J Gastroenterol, 2006, 12(37):5926-5931.
8. 吳志勇, 陳煒.肝硬化門靜脈高壓癥外科治療程序.中國實用外科雜志, 2011, 31(1):39-43.
9. 許永慶, 戴朝六, 卜獻民, 等.門靜脈高壓癥上消化道出血行急診斷流術的治療體會.中國普外基礎與臨床雜志, 2013, 20(1):33-36.
10. 陳亞晗.斷流術與分流術在門靜脈高壓治療的比較.安徽醫藥, 2013, 17(8):1336-1337.
11. 胡建平, 陳軍, 吳松, 等.門脈高壓癥急診改良Sugiura手術體會.肝膽外科雜志, 2010, 18(4):280-283.
12. 武林楓, 劉連新, 趙金鵬, 等.改良Sugiura手術和賁門周圍血管離斷術治療門靜脈高壓癥的療效比較.中華普通外科雜志, 2005, 20(1):24-26.
13. 張賀云, 徐鋆耀, 陳亞進, 等.賁門周圍血管離斷術與改良Sugiura手術治療門靜脈高壓癥的療效比較.中華肝膽外科雜志, 2010, 16(8):586-589.
14. 劉思達, 黎一鳴, 吉鴻, 等.賁門周圍血管離斷術治療門靜脈高壓癥療效的Meta分析.中國普外基礎與臨床雜志, 2014, 21(1):69-75.
15. 中華醫學會外科學分會門靜脈高壓癥學組.肝硬化門靜脈高壓癥食管胃底靜脈曲張破裂出血診治專家共識(2015).中國實用外科雜志, 2015, 35(10):1086-1090.
16. 冷希圣.門靜脈高壓癥斷流手術的爭論.現代外科雜志, 2008, 20(7):497-499.
17. 林折輝, 羅開國, 王曉山, 等.改良Sugiura術橫斷食管與橫斷賁門的療效對比.肝膽外科雜志, 2015, 23(3):225-228.
18. 曹亞娟, 謝敏, 包善華, 等.門靜脈高壓癥消化道出血的臨床特點分析.肝膽外科雜志, 2009, 17(6):415-418.
19. 楊鎮.門靜脈高壓癥的最新外科治療.濟南:山東科學技術出版社, 2005:425-430.
20. 楊鎮.選擇性賁門周圍血管離斷術的發展與手術技巧.中國實用外科雜志, 2009, 29(5):450-451.
21. 冷希圣.肝移植時代門靜脈高壓癥治療策略.中國實用外科雜志, 2009, 19(5):373-376.
22. 任德發, 牛曉泉, 鄭剛, 等.非選擇性與選擇性賁門周圍血管離斷術治療門靜脈高壓癥并上消化道出血86例分析.臨床外科雜志, 2013, 21(4):271-273.
23. 吳性江, 曹建民, 吳學豪, 等.門靜脈高壓癥患者冠狀靜脈解剖變異及臨床意義.中華外科雜志, 2000, 38(2):89-91.
24. 李傳福, 萬旭宏, 陳慶學.腸道細菌易位及炎癥反應綜合征.中國煤炭工業醫學雜志, 2009, 12(9):1479-1480.
25. 姜彤, 趙玉斌.空腸營養置管方法研究進展.解放軍醫藥雜志, 2011, 23(5):94-96.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Modified Sugiura Procedure with Cardia Transection in Treatment of Recurrent Portal Hypertension with Upper Gastrointestinal Bleeding

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