Orozco H, Takahashi T, Mercado M A, Prado E, Chan C
Department of Surgery, Instituto Nacional de la Nutricion Salvador Zubiran, Tlalpan, Mexico City, D.F., Mexico.
World J Surg. 1994 Mar-Apr;18(2):246-50. doi: 10.1007/BF00294409.
Variceal bleeding remains an important complication in extrahepatic portal vein thrombosis (EPVT). As for portal hypertension due to other etiologies, an elective treatment to decrease the risk of subsequent rebleeding is warranted. The results of the Sugiura-Futagawa procedure (SP) in 38 patients with variceal bleeding secondary to EPVT are reported: 20 women and 18 men, with a mean age of 28 +/- 2 years (SEM). Thirty-seven patients were classified as Child-Pugh class A, and one patient as class B. In terms of diagnosis, 45% of patients had idiopathic EPVT, and 18% had associated hypercoagulability disorders; 52% of patients had associated splenic vein thrombosis. The SP was completed in two surgical stages in 18 patients and in one surgical stage in 14; 6 patients had only the abdominal stage. One patient had mild postoperative encephalopathy, and three patients rebled at long-term follow-up study. There were two operative deaths. Actuarial survival was 70% at 64 months. It is concluded that the SP is an excellent alternative for patients with variceal bleeding secondary to EPVT.
静脉曲张出血仍是肝外门静脉血栓形成（EPVT）的一项重要并发症。对于由其他病因引起的门静脉高压症，进行择期治疗以降低后续再出血风险是必要的。本文报告了38例继发于EPVT的静脉曲张出血患者接受杉浦-二川手术（SP）的结果：其中女性20例，男性18例，平均年龄28±2岁（标准误）。37例患者为Child-Pugh A级，1例为B级。在诊断方面，45%的患者为特发性EPVT，18%的患者伴有高凝性疾病；52%的患者伴有脾静脉血栓形成。18例患者分两个手术阶段完成SP，14例在一个手术阶段完成；6例仅进行了腹部手术阶段。1例患者术后出现轻度脑病，3例患者在长期随访研究中再次出血。有2例手术死亡。64个月时的精算生存率为70%。结论是，对于继发于EPVT的静脉曲张出血患者，SP是一种很好的治疗选择。
