Yang Jianyong, Zhang Ling, Yu Shenping, Chen Wei, Huang Wenquan, Feng Gansheng, Liang Huimin
Department of Radiology, First Affiliated Hospital of Sun Yat-Sen University of Medical Sciences, Guangzhou 510080, China.
Chin Med J (Engl). 2003 Jan;116(1):121-4.
To assess a new intervention for reestablishing the second hepatic hilum by means of puncturing and stenting the liver tissue between the intrahepatic vena cava and a hepatic vein for the treatment of Budd-Chiari syndrome (BCS).
Two patients with BCS, in which no second hepatic hilum structure was found in transhepatic venography, underwent an interventional procedure of canalizing and stenting the parenchyma tract between the intrahepatic vena cava and a hepatic vein. The procedures were performed in the percutaneous transhepatic and right jugular vein, respectively. A metallic stent with a 10 mm diameter was implanted to maintain tract patency.
The free hepatic vein pressure (FHVP) of both patients decreased from 37 mm Hg to 5 mm Hg and from 28 mm Hg to 4 mm Hg, respectively, after the procedure. The complication of hemorrhage due to puncture was observed in one patient. Both patients maintained hepatic improvements in 3-year follow-up. Both clinical conditions and laboratory values were significantly improved after the procedure. Furthermore, the stented canals (the reestablished second hepatic hilum) maintained patent with normal FHVP, which was confirmed by control venography.
The new technique provides a simple, safe, effective, and relatively inexpensive treatment of Budd-Chiari syndrome. Long-lasting effectiveness is expected.
通过穿刺肝实质并在肝静脉与肝内静脉之间置入支架重建第二肝门，评估一种治疗布加综合征（BCS）的新干预措施。
2例经肝静脉造影未发现第二肝门结构的布加综合征患者，分别经皮经肝和右颈静脉进行了肝内静脉与肝静脉之间的实质通道开通和支架置入的介入操作。使用直径为10mm的金属支架以维持通道通畅。
术后2例患者的游离肝静脉压（FHVP）分别从37mmHg降至5mmHg和从28mmHg降至4mmHg。1例患者出现穿刺出血并发症。2例患者在3年随访中肝脏情况均维持改善。术后临床状况和实验室检查值均显著改善。此外，经对照静脉造影证实，置入支架的通道（重建的第二肝门）保持通畅，FHVP正常。
新技术为布加综合征提供了一种简单、安全、有效且相对廉价的治疗方法。预期具有长期疗效。
