Yaku H, Shirakata S, Sato S, Sasaki Y, Nakaji S, Oka T, Hashimoto I
Nihon Geka Gakkai Zasshi. 1985 Aug;86(8):948-52.
A 37-year-old man is presented with Budd-Chiari syndrome associated with a membranous obstruction of the inferior vena cava. Clinical symptoms were ascites, leg edema and dilatation of the superficial abdominal veins. Aggressive surgery was carried out for this case. Midsternal incision and right subcostal oblique incision were made, and hepatic segment of the inferior vena cava was reconstructed using pericardial patch after endovenectomy and partial cardiopulmonary bypass was used without temporary interruption of liver circulation. Blood flow from the right hepatic vein was restored. Postoperative course was not eventful and this patient remains free of any evidence of ascites and liver dysfunction after operation. This procedure may be useful particularly for protecting the liver function which is damaged by hemostasis.
一名37岁男性被诊断为布加综合征,伴有下腔静脉膜性梗阻。临床症状为腹水、腿部水肿和腹壁浅静脉扩张。对该病例实施了积极的手术治疗。采用胸骨正中切口和右肋下斜切口,在静脉内膜切除术后,使用心包补片重建下腔静脉肝段,并在部分体外循环下进行手术,未临时阻断肝脏循环。恢复了右肝静脉的血流。术后过程平稳,该患者术后未出现腹水及肝功能异常的迹象。该手术对于保护因止血而受损的肝功能可能尤其有用。