Cornet L, Richard-Kadio M, Mobiot M, N'Guessan H A, Dick R, Aguehounde C, Yakpa P
Ann Gastroenterol Hepatol (Paris). 1984 Jan-Feb;20(1):13-6.
Portal hypertension due to hepato-splenic bilharziasis is common in Abidjan, where we operated on 34 cases in 15 years. The indications for surgical intervention include gastrointestinal haemorrhage due to rupture of esophageal varices, a very bulky enlarged spleen and, more, rarely, recurrent ascites. Simple splenectomy (9 cases) suppresses discomfort and pain, corrects the hypersplenism and brings about a moderate reduction of portal pressure. Spleno-renal anastomosis (19 cases) remains the operation of choice. The long-term results, difficult as these are to assess under ill-regulated African conditions, appear satisfactory on the whole, due to less serious damage to the hepatocyte than in the cirrhoses (62% Child A and 29% Child B). We therefore continue to advocate splenectomy followed if possible by a spleno-renal shunt in bilharzial portal hypertension.
肝脾型血吸虫病所致的门静脉高压在阿比让很常见，15年间我们共为34例患者实施了手术。手术干预的指征包括食管静脉曲张破裂导致的胃肠道出血、脾脏极度肿大，以及较少见的反复腹水。单纯脾切除术（9例）可缓解不适与疼痛，纠正脾功能亢进，并使门静脉压力适度降低。脾肾分流术（19例）仍是首选术式。尽管在非洲条件管理不善的情况下难以评估长期结果，但总体而言似乎令人满意，因为与肝硬化相比，对肝细胞的损害较轻（Child A级占62%，Child B级占29%）。因此，我们继续主张在血吸虫性门静脉高压症中，尽可能先进行脾切除术，然后进行脾肾分流术。
