Dagenais M, Langer B, Taylor B R, Greig P D
Department of Surgery, University of Toronto, Ontario, Canada.
World J Surg. 1994 Mar-Apr;18(2):222-8. doi: 10.1007/BF00294405.
The Sugiura operation has been reported to have low operative mortality, rebleeding, and encephalopathy rates when carried out in a predominantly nonalcoholic Japanese population with good liver function. A literature review of reports of the Sugiura procedure outside Japan reveals a high complication and mortality rate when it is used as an emergency procedure in patients with advanced liver disease, especially in those with alcoholic cirrhosis. Uncontrolled studies report results that differ little from the Japanese series when the operation is confined to good-risk patients in the elective situation. Our experience with the Sugiura operation supports its role in these circumstances, especially in patients with portal vein thrombosis and normal liver function. The only good prospective controlled trial has been carried out in patients with schistosomiasis and suggests that the Sugiura operation is far superior to total shunt and may have a slight advantage over the Warren shunt because of its low incidence of postoperative encephalopathy. More controlled trials are required to establish its role in good- to moderate-risk patients with alcoholic cirrhosis.
据报道，在肝功能良好的非酒精性为主的日本人群中进行杉浦手术时，其手术死亡率、再出血率和脑病发生率较低。对日本以外地区杉浦手术报告的文献综述显示，当该手术用于晚期肝病患者，尤其是酒精性肝硬化患者的急诊手术时，并发症和死亡率较高。非对照研究报告称，当该手术限于择期情况下的低风险患者时，其结果与日本的系列研究结果差异不大。我们对杉浦手术的经验支持其在这些情况下的作用，特别是在门静脉血栓形成且肝功能正常的患者中。唯一一项良好的前瞻性对照试验是在血吸虫病患者中进行的，结果表明杉浦手术远优于全分流术，并且由于术后脑病发生率低，可能比沃伦分流术略有优势。需要更多的对照试验来确定其在中低风险酒精性肝硬化患者中的作用。
