Department of Interventional Radiology, Institute of Liver & Biliary Sciences, New Delhi, India.
Department of Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India.
Br J Radiol. 2021 Apr 1;94(1120):20201157. doi: 10.1259/bjr.20201157. Epub 2021 Feb 17.
Comparing the efficacy, safety and outcome of percutaneous intrervention for Budd-Chiari Syndrome (BCS) patients with bilirubin less than 3 and 3-6 mg dl.
188 BCS patients having serum bilirubin ≤6 mg dl and underwent percutaneous interventions were divided into two groups based on bilirubin level: 151 patients having bilirubin <3 mg dl were included in Group 1; and 37 patients having bilirubin 3-6 mg dl were included in Group 2. Both group were compare for technical success (successful recanalization of hepatic venous stenosis or creation of portocaval shunt with post-procedure gradient ≤5 mm of Hg), Safety (procedure-related mortality/morbidity or patient required transplantation) and outcome (resolution of clinical symptoms and survival).
Technical success was 94.7% in Group 1-89.1% in Group 2 with overall success rate was 93.6%. No significant differences observed between the two groups in regards to procedure related complication. Overall transplant-free survival at 1 and 5 years after intervention in both groups was 96.3 and 91.2% respectively. 1-year and 5-year survivals in Group 1 was 96.7%, and 93.1%, whereas Group 2 was 94.6 and 90.1% with no statically significantly difference between the two groups ( = 0.59). Percutaneous intervention results are good in patients having bilirubin up to 6 mg dl, . mild to moderate liver dysfunctions.
Technical success, survival and outcome of percutaneous intervention in BCS patients having serum bilirubin 3-6 mg dl was comparable to patients having bilirubin level <3 mg dl.
Percutaneous intervention treatment is suitable for treatment for symptomatic BCS patients having bilirubin up to 6 mg dl.
比较胆红素<3mg/dl 和 3-6mg/dl 的布加综合征（BCS）患者经皮介入治疗的疗效、安全性和结局。
188 例血清胆红素≤6mg/dl 且接受经皮介入治疗的 BCS 患者根据胆红素水平分为两组：胆红素<3mg/dl 的 151 例患者纳入第 1 组；胆红素 3-6mg/dl 的 37 例患者纳入第 2 组。比较两组技术成功率（肝静脉狭窄成功再通或建立门腔分流，术后梯度≤5mmHg）、安全性（与操作相关的死亡率/发病率或患者需要移植）和结局（临床症状缓解和生存）。
第 1 组技术成功率为 94.7%，第 2 组为 89.1%，总成功率为 93.6%。两组间与操作相关的并发症无显著差异。两组患者干预后 1 年和 5 年的无移植生存率分别为 96.3%和 91.2%。第 1 组 1 年和 5 年的生存率分别为 96.7%和 93.1%，第 2 组分别为 94.6%和 90.1%，两组间无统计学差异（=0.59）。对于胆红素达 6mg/dl、轻度至中度肝功能不全的患者，经皮介入治疗效果良好。
胆红素 3-6mg/dl 的 BCS 患者经皮介入治疗的技术成功率、生存率和结局与胆红素水平<3mg/dl 的患者相当。
经皮介入治疗适用于治疗胆红素达 6mg/dl 以下的有症状 BCS 患者。
