Karagul Servet, Yagci Mehmet Ali, Tardu Ali, Ertugrul Ismail, Kirmizi Serdar, Sumer Fatih, Isik Burak, Kayaalp Cuneyt, Yilmaz Sezai
Liver Transplantation Institute, Inonu University, Malatya, Turkey.
Ann Transplant. 2016 May 19;21:317-20. doi: 10.12659/aot.898253.
BACKGROUND Idiopathic noncirrhotic portal hypertension (INCPH) is a rare disease characterized by increased portal venous pressure in the absence of cirrhosis and other causes of liver diseases. The aim of the present study was to present our results in using portosystemic shunt surgery in patients with INCPH. MATERIAL AND METHODS Patients who had been referred to our Liver Transplantation Institute for liver transplantation and who had undergone surgery from January 2010 to December 2015 were retrospectively analyzed. Patients with INCPH who had undergone portosystemic shunt procedure were included in the study. Age, sex, symptoms and findings, type of portosystemic shunt, and postoperative complications were assessed. RESULTS A total of 1307 patients underwent liver transplantation from January 2010 to December 2015. Eleven patients with INCPH who did not require liver transplantation were successfully operated on with a portosystemic shunt procedure. The mean follow-up was 30.1±19 months (range 7-69 months). There was no mortality in the perioperative period or during the follow-up. Two patients underwent surgery again due to intra-abdominal hemorrhage; one had bleeding from the surgical site except the portacaval anastomosis and the other had bleeding from the h-graft anastomosis. No patient developed encephalopathy and no patient presented with esophageal variceal bleeding after portosystemic shunt surgery. Shunt thrombosis occurred in 1 patient (9.9%). Only 1 patient developed ascites, which was controlled medically. CONCLUSIONS Portosystemic shunt surgery is a safe and effective procedure for the treatment of patients with INCPH.
特发性非肝硬化性门静脉高压(INCPH)是一种罕见疾病,其特征是在无肝硬化及其他肝病病因的情况下门静脉压力升高。本研究的目的是展示我们对INCPH患者进行门体分流手术的结果。
对2010年1月至2015年12月期间转诊至我们肝脏移植研究所进行肝移植且接受了手术的患者进行回顾性分析。纳入接受门体分流手术的INCPH患者。评估患者的年龄、性别、症状和体征、门体分流类型及术后并发症。
2010年1月至2015年12月共有1307例患者接受肝移植。11例不需要肝移植的INCPH患者成功接受了门体分流手术。平均随访时间为30.1±19个月(范围7 - 69个月)。围手术期及随访期间均无死亡病例。2例患者因腹腔内出血再次手术;1例除门腔静脉吻合处外手术部位出血,另1例h型移植物吻合处出血。门体分流术后无患者发生肝性脑病,也无患者出现食管静脉曲张出血。1例患者(9.9%)发生分流血栓形成。仅1例患者出现腹水,通过药物治疗得到控制。
门体分流手术是治疗INCPH患者的一种安全有效的方法。