Paineau J, Lehur P A, Leborgne J, Lenne Y, Perrin D, Visset J
J Chir (Paris). 1984 Aug-Sep;121(8-9):471-6.
Mortality and quality of survival after portacaval anastomosis in cirrhotic patients are such that the validity of the operation was investigated during a retrospective study of 242 cases, operation being for hemorrhage and involving emergency or delayed surgery. Operative mortality was higher in emergency cases, but was improved by stricter selection criteria, particularly of pathological features. Cause of death from secondary factors varied during the two years following anastomosis, with perhaps a high frequency of hepatic failure. Recurrence of hemorrhage was a serious complication often related to hepatic insufficiency, while the onset of combined jaundice-edema-ascites (1 out of 4 patients) was frequently the result of continued alcohol abuse. Portacaval encephalopathy (24,4%) did not worsen the vital prognosis, and was severe in only 3 cases. Alcohol intoxication was very frequent in minor forms. Edema of the lower limbs (34,4% of cases), a frequent complication, appeared to result mainly from hemodynamic causes. A return to work was not possible in 20% of patients, but in only 12% was this due to the anastomosis. Portacaval anastomosis would not, therefore, appear to alter survival of patients from complications of cirrhosis. It suppresses the hemorrhagic risk, however, and the course of the disease is then related only to the cirrhosis and to its stability if abstinence is maintained.
肝硬化患者门腔静脉吻合术后的死亡率和生存质量表明，在一项对242例病例的回顾性研究中对该手术的有效性进行了调查，手术目的是治疗出血，包括急诊手术或延迟手术。急诊病例的手术死亡率较高，但通过更严格的选择标准，特别是病理特征的选择标准，死亡率有所改善。吻合术后两年内，继发因素导致的死亡原因各不相同，肝衰竭的发生率可能较高。出血复发是一种严重并发症，常与肝功能不全有关，而黄疸-水肿-腹水综合征（4例中有1例）的发生往往是持续酗酒的结果。门腔静脉性脑病（24.4%）并未恶化患者的生命预后，仅3例病情严重。轻度酒精中毒非常常见。下肢水肿（34.4%的病例）是一种常见并发症，似乎主要由血流动力学原因引起。20%的患者无法恢复工作，但其中仅12%是由于吻合术所致。因此，门腔静脉吻合术似乎不会改变肝硬化患者因并发症导致的生存率。然而，它消除了出血风险，并且如果患者保持戒酒，疾病进程仅与肝硬化及其稳定性有关。
