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.	刘洪沨, 李小毅, 刘跃武, 等.门静脉高压症术后消化道再出血的临床研究.中国普外基础与临床杂志, 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.	王文静, 曹国军, 胡青钢.门静脉高压症行断流术后再出血43例诊治体会.中国实用外科杂志, 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.	中华消化内镜学会.食管胃底静脉曲张内镜下诊断和治疗规范试行方案.中华消化内镜杂志, 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.	吴志勇, 陈炜.肝硬化门静脉高压症外科治疗程序.中国实用外科杂志, 2011, 31(1):39-43.
9.	许永庆, 戴朝六, 卜献民, 等.门静脉高压症上消化道出血行急诊断流术的治疗体会.中国普外基础与临床杂志, 2013, 20(1):33-36.
10.	陈亚晗.断流术与分流术在门静脉高压治疗的比较.安徽医药, 2013, 17(8):1336-1337.
11.	胡建平, 陈军, 吴松, 等.门脉高压症急诊改良Sugiura手术体会.肝胆外科杂志, 2010, 18(4):280-283.
12.	武林枫, 刘连新, 赵金鹏, 等.改良Sugiura手术和贲门周围血管离断术治疗门静脉高压症的疗效比较.中华普通外科杂志, 2005, 20(1):24-26.
13.	张贺云, 徐鋆耀, 陈亚进, 等.贲门周围血管离断术与改良Sugiura手术治疗门静脉高压症的疗效比较.中华肝胆外科杂志, 2010, 16(8):586-589.
14.	刘思达, 黎一鸣, 吉鸿, 等.贲门周围血管离断术治疗门静脉高压症疗效的Meta分析.中国普外基础与临床杂志, 2014, 21(1):69-75.
15.	中华医学会外科学分会门静脉高压症学组.肝硬化门静脉高压症食管胃底静脉曲张破裂出血诊治专家共识(2015).中国实用外科杂志, 2015, 35(10):1086-1090.
16.	冷希圣.门静脉高压症断流手术的争论.现代外科杂志, 2008, 20(7):497-499.
17.	林折辉, 罗开国, 王晓山, 等.改良Sugiura术横断食管与横断贲门的疗效对比.肝胆外科杂志, 2015, 23(3):225-228.
18.	曹亚娟, 谢敏, 包善华, 等.门静脉高压症消化道出血的临床特点分析.肝胆外科杂志, 2009, 17(6):415-418.
19.	杨镇.门静脉高压症的最新外科治疗.济南:山东科学技术出版社, 2005:425-430.
20.	杨镇.选择性贲门周围血管离断术的发展与手术技巧.中国实用外科杂志, 2009, 29(5):450-451.
21.	冷希圣.肝移植时代门静脉高压症治疗策略.中国实用外科杂志, 2009, 19(5):373-376.
22.	任德发, 牛晓泉, 郑刚, 等.非选择性与选择性贲门周围血管离断术治疗门静脉高压症并上消化道出血86例分析.临床外科杂志, 2013, 21(4):271-273.
23.	吴性江, 曹建民, 吴学豪, 等.门静脉高压症患者冠状静脉解剖变异及临床意义.中华外科杂志, 2000, 38(2):89-91.
24.	李传福, 万旭宏, 陈庆学.肠道细菌易位及炎症反应综合征.中国煤炭工业医学杂志, 2009, 12(9):1479-1480.
25.	姜彤, 赵玉斌.空肠营养置管方法研究进展.解放军医药杂志, 2011, 23(5):94-96.

1. 刘洪沨, 李小毅, 刘跃武, 等.门静脉高压症术后消化道再出血的临床研究.中国普外基础与临床杂志, 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. 王文静, 曹国军, 胡青钢.门静脉高压症行断流术后再出血43例诊治体会.中国实用外科杂志, 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. 中华消化内镜学会.食管胃底静脉曲张内镜下诊断和治疗规范试行方案.中华消化内镜杂志, 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. 吴志勇, 陈炜.肝硬化门静脉高压症外科治疗程序.中国实用外科杂志, 2011, 31(1):39-43.
9. 许永庆, 戴朝六, 卜献民, 等.门静脉高压症上消化道出血行急诊断流术的治疗体会.中国普外基础与临床杂志, 2013, 20(1):33-36.
10. 陈亚晗.断流术与分流术在门静脉高压治疗的比较.安徽医药, 2013, 17(8):1336-1337.
11. 胡建平, 陈军, 吴松, 等.门脉高压症急诊改良Sugiura手术体会.肝胆外科杂志, 2010, 18(4):280-283.
12. 武林枫, 刘连新, 赵金鹏, 等.改良Sugiura手术和贲门周围血管离断术治疗门静脉高压症的疗效比较.中华普通外科杂志, 2005, 20(1):24-26.
13. 张贺云, 徐鋆耀, 陈亚进, 等.贲门周围血管离断术与改良Sugiura手术治疗门静脉高压症的疗效比较.中华肝胆外科杂志, 2010, 16(8):586-589.
14. 刘思达, 黎一鸣, 吉鸿, 等.贲门周围血管离断术治疗门静脉高压症疗效的Meta分析.中国普外基础与临床杂志, 2014, 21(1):69-75.
15. 中华医学会外科学分会门静脉高压症学组.肝硬化门静脉高压症食管胃底静脉曲张破裂出血诊治专家共识(2015).中国实用外科杂志, 2015, 35(10):1086-1090.
16. 冷希圣.门静脉高压症断流手术的争论.现代外科杂志, 2008, 20(7):497-499.
17. 林折辉, 罗开国, 王晓山, 等.改良Sugiura术横断食管与横断贲门的疗效对比.肝胆外科杂志, 2015, 23(3):225-228.
18. 曹亚娟, 谢敏, 包善华, 等.门静脉高压症消化道出血的临床特点分析.肝胆外科杂志, 2009, 17(6):415-418.
19. 杨镇.门静脉高压症的最新外科治疗.济南:山东科学技术出版社, 2005:425-430.
20. 杨镇.选择性贲门周围血管离断术的发展与手术技巧.中国实用外科杂志, 2009, 29(5):450-451.
21. 冷希圣.肝移植时代门静脉高压症治疗策略.中国实用外科杂志, 2009, 19(5):373-376.
22. 任德发, 牛晓泉, 郑刚, 等.非选择性与选择性贲门周围血管离断术治疗门静脉高压症并上消化道出血86例分析.临床外科杂志, 2013, 21(4):271-273.
23. 吴性江, 曹建民, 吴学豪, 等.门静脉高压症患者冠状静脉解剖变异及临床意义.中华外科杂志, 2000, 38(2):89-91.
24. 李传福, 万旭宏, 陈庆学.肠道细菌易位及炎症反应综合征.中国煤炭工业医学杂志, 2009, 12(9):1479-1480.
25. 姜彤, 赵玉斌.空肠营养置管方法研究进展.解放军医药杂志, 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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