门静脉高压症外科治疗的进展

The advances in surgery for cirrhotic portal hypertension in China

肝硬化门静脉高压症在全球均十分常见,严重危害患者生命。近三十余年来,药物、内镜、介入及肝移植等治疗方法的兴起与临床广泛应用,使传统的门静脉高压症的外科治疗面临前所未有的严峻挑战。尽管如此,在现今多学科协作(MDT)诊疗模式中,外科手术仍发挥着不可替代的作用。腹腔镜下贲门周围血管离断术因具有手术损伤小、出血量少、术后恢复快、并发症发生率低、疗效确切等优点,得到了较好推广。应强调在MDT诊疗模式下重视新方法、新技术与新理念的开展与应用,充分发挥各学科优势,对门静脉高压症患者实施规范化、个体化与精准化治疗,使患者的临床获益最大化。

The cirrhotic portal hypertension is very common worldwide and poses a serious threat to the health of patients.Over past three decades,the surgical treatment for cirrhotic portal hypertension was strongly challenged by the drugs,endoscopy,interventional therapy and liver transplantation.However,under the multidisciplinary team(MDT)cooperative diagnosis and treatment mode,the surgical treatment still plays a unique and irreplaceable role.Laparoscopic pericardial vascular devascularization is characterized by less injury and bleeding,rapid postoperative recovery,which will coexist with open surgery for portal hypertension.It is important to focus on the development and application of new methods,new technologies and new concepts under the MDT cooperative diagnosis and treatment mode,giving full play to the advantages of each discipline and advocate standardized,individualized and precise treatment should be emphasized to maximize patient clinical benefits.