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Two surgical procedures for esophagogastric variceal bleeding in patients with portal hypertension

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World Journal of Gastroenterology 2013年第48期19卷 9418-9424页

作者： Lin Yang Li-Juan Yuan Rui Dong Ji-Kai Yin Qing Wang Tao Li Jiang-Bin Li Xi-Lin Du Jian-Guo Lu Department of General Surgery Tangdu Hospital of the Fourth Military Medical University

AIM:To determine the clinical value of a splenorenal shunt plus pericardial devascularization(PCVD)in portal hypertension(PHT)patients with variceal ***:From January 2008 to November 2012,290 patients with cirrhotic portal hypertension were treated surgically in our department for the prevention of gastroesophageal variceal bleeding:207 patients received a routine PCVD procedure(PCVD group),and83 patients received a PCVD plus a splenorenal shunt procedure(combined group).Changes in hemodynamic parameters,rebleeding,encephalopathy,portal vein thrombosis,and mortality were ***:The free portal pressure decreased to 21.43±4.35 mmHg in the combined group compared with24.61±5.42 mmHg in the PCVD group(Psplenorenal shunt is an effective and safe strategy to control esophagogastric variceal bleeding in *** should be recommended as a first-line treatment for preventing bleeding in PHT patients when surgical interventions are considered.

关键词： Comparative study Portal hypertension splenorenal shunt Devascularization Esophagogastric variceal bleeding

Rectal arterio-portal fistula: An unusual cause of persistent bleeding per rectum following a proximal spleno-renal shunt

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World Journal of Gastroenterology 2013年第25期19卷 4087-4090页

作者： Hao Yun Yap Ser Yee Lee Yaw Fui Alexander Chung Kiang Hiong Tay Albert Su-Chong Low Choon Hua Thng Krishnakumar Madhavan Department of General Surgery Singapore General Hospital Department of Surgical Oncology National Cancer Centre Singapore Department of Diagnostic Radiology Singapore General Hospital Department of Oncologic Imaging National Cancer Centre Singapore Department of General Surgery National University Hospital Singapore

Gastrointestinal arterio-venous malformations are a known cause of gastrointestinal bleeding. We present a rare case of persistent rectal bleeding due to a rectal arterio-portal venous fistula in the setting of portal hypertension secondary to portal vein thrombosis. The portal hypertension was initially surgically treated with splenectomy and a proximal splenorenal shunt. However, rectal bleeding persisted even after surgery, presenting us with a diagnostic dilemma. The patient was re-evaluated with a computed tomography mesenteric angiogram which revealed a rectal arterio-portal fistula. Arterio-portal fistulas are a known but rare cause of portal hypertension, and possibly the underlying cause of continued rectal bleeding in this case. This was successfully treated using angiographic localizationand super-selective embolization of the rectal arterioportal venous fistula via the right internal iliac artery. The patient subsequently went on to have a full term pregnancy. Through this case report, we hope to high-light awareness of this unusual condition, discuss the diagnostic workup and our management approach.

关键词： Portal hypertension Esophageal varices splenorenal shunt Arteriovenous malformations Portal vein thrombosis

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门脉高压症远脾肾分流与门奇断流术疗效比较

解放军医药杂志 1994年第3期16卷 167-169页

作者：谭海东兆坡刘继英张利辉赵金良郝凤伟白求恩国际和平医院

提要本文报告177例采用远脾肾分流术和门奇断流两种术式治疗门脉高压症的分析比较。两组在肝功能分级的选择上差异无显著意义。同一手术组肝功能分级与生存时间之间差异无显著意义。分流组与断流组1、3、5、10年生存率分别为98.63%、94... 详细信息

提要本文报告177例采用远脾肾分流术和门奇断流两种术式治疗门脉高压症的分析比较。两组在肝功能分级的选择上差异无显著意义。同一手术组肝功能分级与生存时间之间差异无显著意义。分流组与断流组1、3、5、10年生存率分别为98.63%、94.31%、90.87%、81.43%和94.78%、90.21%、86.28%、79.38%。手术死亡率分别为5.5%和4.7%,再出血率分别为12.3%和13.5%。脑病发病率为0%,两组疗效均较满意,分流组生存率优于断流组。

关键词：肝硬化 hepatic cirrosis 门脉高压症 portal hypertension 远端脾肾分流术 distal splenorenal shunt 门奇静脉断流术 block of portal and azygos vein

Renal venous hypertension

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World Journal of Hypertension 2016年第1期6卷 60-65页

作者： Makhmud Muslimovich Аliev Rustam Zafarjanovich Yuldashev Gulnora Srajitdinovna Аdilova Аvazjon Аbdunomonovich Dekhqonboev Department of Pediatric Surgery Republican Specialized Scientific Practical Medical Centre of Pediatrics

Renal venous hypertension usually seen in young, otherwise healthy individuals and can lead to significant overall morbidity. Aside from clinical findings and physicalexamination, diagnosis can be made with ultrasound, computed tomography, or magnetic resonance conventional venography. Symptoms and haemodynamic significance of the compression determine the ideal treatment method. This review of the literature discusses normal and pathological developmental aspects of renocaval venous segment and related circulatory disorders, summarizes congenital and acquired changes in left renal vein and their impact on development of renal venous hypertension. Also will be discussed surgical tactics of portosystemic shunting and their potential effects on renal hemodynamics.

关键词： Renal venous hypertension Nutcracker syndrome Kidney Portal hypertension splenorenal shunts