改良Sugiura手术治疗门静脉高压症39例体会

李世功; 李汛; 杨含腾; 刘茂年; 裴爱华; 梁育川; 杨晓东; 邢文军; 徐风兰

改良Sugiura手术治疗门静脉高压症39例体会

1. 甘肃省武威肿瘤医院肝胆外科
2. 兰州大学第一医院肝胆外科

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中图分类号: R657.34
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出版历程
- 出版日期: 2013-03-20

Clinical outcome of the modified Sugiura procedure for treatment of portal hypertension

摘要

摘要:
目的探讨改良Sugiura手术治疗门静脉高压症的安全性和有效性。方法回顾性分析2009年9月至2012年3月39例改良Sugiura手术治疗门静脉高压症的临床资料。结果手术死亡率为0,术后无吻合口漏、腹腔感染及肝性脑病的发生,1例术后继发腹腔出血经再次手术止血;39例术后均行胃镜检查,显示食管胃底静脉曲张明显减轻或消失;随访时间6～18个月,无肝性脑病和消化道再出血者,患者术后生活质量较术前有不同程度提高。结论改良的Sugiura手术具有断流彻底、安全性高、再出血少等特点,并未增加手术风险,近期疗效满意,远期疗效有待进一步随访。
- 高血压,门静脉 /
- 食管和胃静脉曲张 /
- 改良Sugiura
Abstract:
Objective To study the safety and efficacy of the modified Sugiura procedure for treating patients with portal hypertension.Methods Thirty-nine patients with portal hypertension who underwent surgical treatment with the modified Sugiura procedure between September 2009 and March 2011 were retrospectively enrolled in the study.Perioperative and clinical (in-hospital and 6-18 months follow-up) data were assessed.Results The surgeries were successfully completed in all cases.None of the cases experienced post-operative stomal leakage, pyoperitoneum, or hepatic encephalopathy.One patient developed secondary intra-abdominal bleeding that was resolved by resuturing of the affected gastric vein.Gastroscopy at one-month follow-up showed that the esophageal varices had disappeared or been remarkably ameliorated in all patients.None of the cases experienced hepatic encephalopathy or rebleeding after the gastroscopic procedure.All patients survived.Conclusion The modified Sugiura procedure has low rates of postoperative mobidity and complications, and is a safe and effective surgical procedure for portal hypertension.
- hypertension /
- portal /
- esophageal and gastric varices

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参考文献(14)

[1]Orozco H, Mercado MA.Devascularizations in portal hypertension[J].J Am Coll Surg, 2002, 194 (2) :247-249.

[2]杨连粤, 刘振.门静脉高压症并上消化道出血的外科治疗进展[J].临床外科杂志, 2007, 15 (3) :162-163.

[3]霍新合, 田博成, 韦晓景, 等.联合断流术治疗门静脉高压症并急性上消化道大出血[J].中国普通外科杂志, 2002, 11 (1) :56-57.

[4]何显力, 马庆久, 高德明, 等.食管曲张静脉破裂大出血患者出血停止后的近期手术治疗:附52例报告[J].中国普通外科杂志, 2004, 13 (1) :40-43.

[5]许培钦, 党晓卫.门静脉高压症的诊断与术式选择[J].中国普通外科杂志, 2006, 15 (12) :881-883.

[6]Liv J, Zhang SG, Wei WM, et al.Clinical Value of hand-assistedlaparoscopic modified sugiura procedure in idiopathic portal hyper-tension[J].J Med Res, 2012, 41 (9) :139-142. (in Chinese) 刘佳, 张绍庚, 魏炜明, 等.手助腹腔镜改良Sugiura术在特发性门静脉高压症的临床应用[J].医学研究杂志, 2012, 41 (9) :139-142.

[7]Mathur SK, Shah SR, Naqral SS, et al.Transabdominal extensiveesophagogastric devascularization with gastroesophageal stapling formanagement of noncirrhotic portal hypertension:long-term results[J].World J Surg, 1999, 23 (11) :1168-1175.

[8]Zhang WH, Liu ZX, Hao M, et al.Clinical evaluation of the im-proved Sugiura surgery for portal hypertension[J].Chin J Mod OperSurg, 2010, 14 (4) :257-259. (in Chinese) 张文华, 刘占祥, 郝铭, 等.改良Sugiura手术治疗门静脉高压症18例疗效观察[J].中国现代手术学杂志, 2010, 14 (4) :257-259.

[9]庞典付, 龚腊梅, 张克难, 等.改良Sugiura手术治疗门静脉高压症[J].中国普通外科杂志, 2008, 17 (7) :729-730.

[10]Sugiura M, Futagawa S.Esophageal transection with paraesophagas-tric devascularizations (the Sugiura procedure) in the treatment of e-sophageal varices[J].World J Surg, 1984, 8 (5) :673-679.

[11]Huang YT, Wang WM, Wang JQ, et al.Surgial treatment of portalhypertension:45 year experience[J].Chin J Surg, 2000, 38 (2) :85-88.

[12]李梅生, 梁力建.门静脉高压症分流及断流手术的利弊[J].中国实用外科杂志, 2001, 21 (3) :180-182.

[13]潘一明, 谢敏, 黄晶, 等.改良Sugiura术式治疗门脉高压症疗效分析[J].肝胆胰外科杂志, 2010, 22 (2) :138-139.

[14]Liu Q, Xiong X, Xiong YL, et al.Analysis of the complications of300 cases with portal hypertension treated with the combined esoph-agogastric devascularization[J].J Clin Emerg Call, 2009, 10 (2) :86-88. (in Chinese) 刘强, 熊仙, 熊育良, 等.经腹联合断流治疗门脉高压症的手术并发症300例[J].临床急诊杂志, 2009, 10 (2) :86-88.

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