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.	汪忠镐.汪忠镐血管外科学[M].杭州:浙江科学技术出版社, 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.	汪忠镐, 李春民, 谷涌泉, 等.疑难重症或介入后复发布-加综合征的治疗[J].中华外科杂志, 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.	孟庆义, 马波民, 张帆.布加综合征650例诊治体会[J].临床和实验医学杂志, 2003, 2(4):209-213.
8.	孟庆义.布加综合征介入治疗与外科手术:外科医师的选择[J].介入放射学杂志, 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.	崔进国, 冯艳皎, 冯子坛, 等.节段性狭窄闭塞布加综合征的介入治疗[J].中华外科杂志, 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.	顾玉明, 祖茂衡, 徐浩, 等.500例Budd-Chiari综合征介入治疗并发症分析[J].中华放射学杂志, 2003, 37(12):1083-1086.
18.	项军, 朱耀青, 王岩, 等.不同球囊导管治疗下腔静脉阻塞的回顾性分析[J].徐州医学院学报, 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, 王爱林, 等.国产ZQL型可回收式腔静脉滤器的初步临床应用与观察[J].中华放射学杂志, 2003, 37(3):228-231.
21.	徐忠立.巴德-恰瑞综合征[M].郑州:河南医科大学出版社, 2001:249-262.
22.	汪忠镐, 王仕华, 吴继东, 等.球囊导管扩张和腔内支架置放法治疗布加综合征[J].中华医学杂志, 1995, 75(2):97-99.
23.	韩新巍, 李永东.布-加综合征介入治疗技术操作规范的几点建议[J].介入放射学杂志, 2002, 11(4):316-318.
24.	祖茂衡, 张庆桥, 顾玉明, 等.血管内支架在布-加综合征远期疗效再评价[J].当代医学:中国介入放射学, 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.	孙俊凯, 李欣, 郑传胜, 等.第二肝门重建术治疗肝静脉阻塞型Budd-Chiari综合征[J].临床放射学杂志, 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. 汪忠镐.汪忠镐血管外科学[M].杭州:浙江科学技术出版社, 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. 汪忠镐, 李春民, 谷涌泉, 等.疑难重症或介入后复发布-加综合征的治疗[J].中华外科杂志, 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. 孟庆义, 马波民, 张帆.布加综合征650例诊治体会[J].临床和实验医学杂志, 2003, 2(4):209-213.
8. 孟庆义.布加综合征介入治疗与外科手术:外科医师的选择[J].介入放射学杂志, 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. 崔进国, 冯艳皎, 冯子坛, 等.节段性狭窄闭塞布加综合征的介入治疗[J].中华外科杂志, 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. 顾玉明, 祖茂衡, 徐浩, 等.500例Budd-Chiari综合征介入治疗并发症分析[J].中华放射学杂志, 2003, 37(12):1083-1086.
18. 项军, 朱耀青, 王岩, 等.不同球囊导管治疗下腔静脉阻塞的回顾性分析[J].徐州医学院学报, 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, 王爱林, 等.国产ZQL型可回收式腔静脉滤器的初步临床应用与观察[J].中华放射学杂志, 2003, 37(3):228-231.
21. 徐忠立.巴德-恰瑞综合征[M].郑州:河南医科大学出版社, 2001:249-262.
22. 汪忠镐, 王仕华, 吴继东, 等.球囊导管扩张和腔内支架置放法治疗布加综合征[J].中华医学杂志, 1995, 75(2):97-99.
23. 韩新巍, 李永东.布-加综合征介入治疗技术操作规范的几点建议[J].介入放射学杂志, 2002, 11(4):316-318.
24. 祖茂衡, 张庆桥, 顾玉明, 等.血管内支架在布-加综合征远期疗效再评价[J].当代医学:中国介入放射学, 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. 孙俊凯, 李欣, 郑传胜, 等.第二肝门重建术治疗肝静脉阻塞型Budd-Chiari综合征[J].临床放射学杂志, 2009, 28(10):1435-1439.

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Analysis of Operation and Prognosis of Budd-Chiari Syndrome

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