Zou Z S, Li J S, Li N, Liu F K
Department of Abdominal Surgery, Jinling Hospital, Nanjing.
Chin Med J (Engl). 1990 Dec;103(12):978-85.
Intraoperative coronary venography was performed in 24 patients before and after portal-azygos disconnection for portal hypertension. Before the procedure the portal vein was found to be communicated with cardial and esophageal veins by two pathways, i,e., from the esophageal and gastric branches of the coronary vein to the esophageal varices, with the latter branches by way of the gastric intramural venula. The portal blood flow was postulated to be hepatofugal because the portal trunk could not be seen venographically. Coronary venography done after the disconnection revealed no pericardial and esophageal varices and the portal vein with hepatopetal blood flow. We conclude that the operation had the advantage of complete disconnection between the portal vein and the cardio-esophageal varices, thus preventing the bleeding from the varix and increasing hepatopetal blood flow.
对24例门静脉高压症患者在门奇静脉断流术前后进行了术中冠状静脉造影。术前发现门静脉通过两条途径与心脏和食管静脉相通，即从冠状静脉的食管和胃分支到食管静脉曲张，后者通过胃壁内小静脉分支。由于静脉造影未显示门静脉主干，推测门静脉血流为离肝血流。断流术后的冠状静脉造影显示无心包和食管静脉曲张，门静脉呈向肝血流。我们得出结论，该手术的优点是门静脉与心-食管静脉曲张完全断流，从而防止曲张静脉出血并增加向肝血流。
