改良Sugiura手术治疗门静脉高压症39例体会

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

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。

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.