Department of General Surgery, Nanchang Number 9 Hospital, Nanchang, Jiangxi, China (mainland).
Medical College of Nanchang University, Nanchang, Jiangxi, China (mainland).
Med Sci Monit. 2023 Mar 7;29:e938998. doi: 10.12659/MSM.938998.
BACKGROUND Splenic artery steal syndrome (SASS) can aggravate liver damage in patients with cirrhosis. This study explored whether SASS could be an effective therapeutic target for improving hepatic artery perfusion and liver function in patients with decompensated cirrhosis. MATERIAL AND METHODS Based on inclusion and exclusion criteria, 87 patients with hepatitis B cirrhosis and portal hypertension hypersplenism admitted to our General Surgery Department for splenectomy and pericardial devascularization surgery were selected. A total of 35 cases met the diagnostic criteria of SASS and were assigned to the SASS group; the remaining 52 cases were assigned to the control group. The indicators before, during, and after surgery were compared between the 2 groups. RESULTS There were no significant differences in preoperative and intraoperative indicators between SASS group and control group (P>0.05). The MELD score 7 days after surgery and the hepatic artery diameter and hepatic artery velocity 14 days after surgery in both groups were significantly better than before surgery. The MELD score 7 days after surgery in the SASS group was significantly better than that in the control group, and the hepatic artery diameter and hepatic artery velocity 14 days after surgery in the SASS group were significantly better than those in the control group (P<0.05). CONCLUSIONS Splenectomy and pericardial devascularization surgery was an effective treatment to redirect blood flow to the hepatic artery for cirrhotic patients diagnosed with SASS. The introduction of cirrhotic SASS into clinical practice may benefit more patients with cirrhotic portal hypertension and hypersplenism.
脾动脉盗血综合征(SASS)可加重肝硬化患者的肝损伤。本研究旨在探讨 SASS 是否可作为改善失代偿期肝硬化患者肝动脉灌注和肝功能的有效治疗靶点。
根据纳入和排除标准,选取我院普外科收治的乙型肝炎肝硬化合并门静脉高压性脾亢患者 87 例,行脾切除术联合贲门周围血管离断术。共 35 例符合 SASS 诊断标准,纳入 SASS 组;余 52 例患者纳入对照组。比较两组患者手术前后的各项指标。
SASS 组与对照组患者术前和术中的各项指标比较,差异均无统计学意义(P>0.05)。两组患者术后第 7 天 MELD 评分及术后第 14 天肝动脉直径、肝动脉流速均明显优于术前,SASS 组患者术后第 7 天 MELD 评分明显优于对照组,术后第 14 天肝动脉直径、肝动脉流速明显优于对照组,差异均有统计学意义(P<0.05)。
脾切除术联合贲门周围血管离断术是治疗确诊为 SASS 的肝硬化患者的一种有效血流再分配方法。将肝硬化 SASS 引入临床实践可能会使更多的肝硬化门静脉高压伴脾亢患者受益。