Liverani Andrea, Solinas Luigi, Di Cesare Tatiana, Velari Luca, Neri Tiziano, Cilurso Francesco, Favi Francesco, Bizzarri Giancarlo
Andrea Liverani, Luigi Solinas, Tatiana Di Cesare, Tiziano Neri, Francesco Cilurso, Francesco Favi, Department of General Surgery, Regina Apostolorum Hospital, 00100 Rome, Italy.
World J Gastroenterol. 2015 Jan 21;21(3):997-1000. doi: 10.3748/wjg.v21.i3.997.
Abdominal surgery in cirrhotic patients with portal hypertension is associated with high incidence of disease and mortality. In these patients, oncological gastric procedures with lymph-nodes dissection show much higher complication rates than in normotensive portal vein patients. Thus, normalization of portal vein pressure may be a favorable determinant factor to reduce complications. We report a case of a patient with hepatitis C virus-related hepatic cirrhosis, esophageal varices, portal hypertension and gastric cancer. We demonstrated the efficacy of a preoperative trans-jugular porto-systemic shunt to perform oncological radical resection more safely. We retained preoperative the trans-jugular porto-systemic shunt in the patients with elevated portal pressure and gastric cancer to perform a gastrectomy more safely and to decrease morbidity and mortality of these cases.
门静脉高压的肝硬化患者进行腹部手术时，疾病发生率和死亡率较高。在这些患者中，进行淋巴结清扫的肿瘤性胃部手术的并发症发生率比门静脉血压正常的患者高得多。因此，门静脉压力正常化可能是降低并发症的一个有利决定因素。我们报告一例丙型肝炎病毒相关性肝硬化、食管静脉曲张、门静脉高压和胃癌患者。我们证明了术前经颈静脉肝内门体分流术能更安全地进行肿瘤根治性切除术。对于门静脉压力升高且患有胃癌的患者，我们在术前保留经颈静脉肝内门体分流术，以便更安全地进行胃切除术，并降低这些病例的发病率和死亡率。
