门静脉海绵样变并发症的治疗研究

The Treatment of The Complications of Cavernous Transformation of Portal Vein

目的探讨门静脉海绵样变并发症的治疗方式。方法对25例门静脉海绵样变患者的30次治疗资料进行回顾分析。结果5例患者行脾栓塞，2例患者栓塞后再次出现脾亢，行开腹脾切除；7例患者行腹腔镜脾切除，术中2例中转开腹手术；7例患者单纯脾切除，1例患者术后3年再行贲门周围血管离断；11例患者行脾切除＋贲门周围血管离断，1例术后4年再行硬化荆治疗。结论对于门静脉海绵样变的手术方式以彻底的断流术为佳，单纯脾切除仅在食道下段及胃底静脉曲张不明显情况下适用。

Objective To study the treatment of the complications of Cavernous Transformation of Portal Vein （CTPV）. Methods Retrospective analysis was used for the clinical data of 25 CTPV cases （30 treatments） during October 2001 and June 2010. Results Splenic Embolization was used in 5 cases, and because of hypersplenism, 2 cases of them underwent open splenectomy after Splenic Embolization. 7 cases undei＇went laparoscopic splenectomy, and the treatment of 2 cases of them were changed to open splenectomy in operation. 7 cases underwent open splenectomy, 1 case underwent splenectomy with periesophagogastric devaseularization in 3 years after operation. The other 11 operations were splenectomy with periesophagogastric devascularlzation, and 1 case underwent injection sclerotherapy. Conclusions The best style of the treatments to CTPV was splenectomy with periesophagogastric devascularization, and open splenectomy was the choice only under the condition of no varicosis in fundus and the inferior segment of esophagus.