胆汁性肝硬化门脉高压症的治疗

SURGICAL THERAPY FOR PORTAL HYPERTENSION IN SECONDARY BILIARY CIRRHOSIS

目的 探讨肝胆管结石、胆管狭窄所致胆汁性肝硬化门脉高压症的外科治疗。方法 总结了我院 14例中、晚期胆汁性肝硬化门脉高压症的临床特征、手术方式及效果。结果 脾切除、胃冠状静脉栓塞改良术式 8例 ;脾切除、贲门周围血管离断改良术式 5例 ;脾动脉结扎、胃周血管离断 1例。随访 0 .5～ 5年 ,2例死亡 (14 .3 % )。患者肝功能好转率 71.4 % (10 /14 )。食道静脉曲张好转率 64.3 % (9/14 )。消化道出血 3例 ,再出血率 2 1.4 %。结论 治疗过程中应充分认识中、晚期胆汁性肝硬化门脉高压症的临床特征。创伤较小 。

Objective To improve the surgical treatment for portal hypertension in secondary biliary cirrhosis.Methods 14 cases with portal hypertension in secondary biliary cirrhosis were analyzed retrospectively for clinical features,operation program and clinic results.Results 8 cases underwent coronary venous embolizing therapy and splenectomy.Trans ligation of pericardial vein and splenectomy were performed in 5 cases.1 cases unederwent ligation of perigastric vein and splenic artery.2 cases(14.3%) died during 5 years.Liver function was improved in 10 cases(74.1%).Varix of esophagus were ameliorated in 9 cases(64.3%).The rebleeding rate was 21.4%.Conclusion It is very important to understande the clinical features of the patient with portal hypertension in secondary biliary cirrhosis.The disconnection procedure is satisfactory with a low incidence of complication in the treatment of portal hypertension in secondary biliary cirrhosis.