经胸吻合器联合断流加大网膜包肺治疗门奇断流术后再出血的疗效观察

Curative Observation on Treatment of Rebleeding after Transthoracic Stapler Combined with Esophagogastric Devascularization Operation with Greater Omentum Packing the Lung

目的:探讨和分析经胸吻合器联合断流加大网膜包肺治疗门脉高压断流术后再出血的手术治疗效果。方法:对2001年3月—2011年8月间采用经胸吻合器联合断流加大网膜包肺手术治疗门静脉高压症行门奇断流术后上消化道再出血的9例患者进行回顾性临床分析。结果:随访1～10年,术后门静脉(SV)血流量、最大流速、门静脉内径均有所下降,1例于术后6年再次上消化道出血导致死亡,其余病例生存质量较好。结论:经胸吻合器联合断流加大网膜包肺术适合于断流术后食管静脉曲张再出血的患者,其术后门脉系统血流动力学稳定,是较为理想的手术方式。

Objective：To discuss and analyze the effect of surgical treatment of rebleeding after transthoracic stapler combined with esophagogastric devascularization operation with greater omentum packing the lung. Methods： Retrospec- tive clinical analysis was made in 9 cases of upper gastrointestinal rebleeding after transthoracic stapler combined with esophagogastric devascularization operation with greater omentum packing the lung for portal hypertension patients be- tween Mar. 2001 and Aug. 2011. Results： A 10-year follow-up study was made, blood flow, maximum velocity and diam- eter of portal vein（SV） were all decreased after operation,one death caused by upper gastrointestinal rebleeding at the 6th years after operation, the remain cases have un living quality quite well. Conclusion：Transthoracic stapler combined with esophagogastric devascularization operation with greater omcntum packing the lung is suitable for patients with e- sophageal varices rebleeding after devascularization operation. For the portal system hemodynamics keep stable after op- eration,it turns to be an ideal surgical method.