Lytkin M I, Zubarev P N, Kalashnikov S A
Vestn Khir Im I I Grek. 2001;160(1):101-5.
The authors present a report of 14 patients with the syndrome of portal hypertension without liver cirrhosis and with recurring esophagogastric bleedings. The cause of the alterations in portal hemodynamics remains unknown. Operative treatments (splenorenal shunts in 9 cases, 3 splenectomies and 1 ligation of the splenic artery) were successful. Two patients in whom splenectomy had been performed in combination with omentohepatopexy died 6 and 10 years after operation due to recurrent hemorrhages. The other patients did not have recurrent bleedings, but in 6 patients 6-10 years after splenorenal shunts there appeared other diseases (encephalopathy, nephrolithiasis, arterial hypertension, duodenal ulcer). The authors consider that indications for shunting operations for idiopathic portal hypertension, especially when using renal veins, should be determined more carefully, phlebosclerotic therapy and transsection of the esophagus being recommended as alternative interventions.
作者报告了14例无肝硬化且反复出现食管胃出血的门静脉高压综合征患者。门静脉血流动力学改变的原因尚不清楚。手术治疗（9例脾肾分流术、3例脾切除术和1例脾动脉结扎术）取得成功。2例接受脾切除术联合大网膜肝固定术的患者术后6年和10年因复发出血死亡。其他患者未出现复发出血，但在脾肾分流术后6 - 10年，6例患者出现了其他疾病（脑病、肾结石、动脉高血压、十二指肠溃疡）。作者认为，对于特发性门静脉高压的分流手术指征，尤其是在使用肾静脉时，应更谨慎地确定，建议采用静脉硬化疗法和食管横断术作为替代干预措施。
