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• W2346492362 abstract "Budd-Chiari syndrome (BCS) is defined as a heterogeneous group of disorders characterized by hepatic venous out flow obstruction at the level of the hepatic venules, the large hepatic veins (HVs), the inferior vena cava (IVC), or the right atrium. During 36 years, we operated on 68 patients with BCS by our devised surgical method which comprised reconstruction of the occluded or severely stenosed IVC using an autologous pericardium patch and reopening as many occluded HVs as possible under cardiopulmonary bypass. The operative procedures could decrease high portal pressure, resulted in disappearance of esophageal varices (EVs), which reflects portal pressure and is one of the fatal factors of BCS. We verify the effects of our operative method by evaluating postoperative course of EVs. Two patients died in-hospital (operative mortality, 2.94%) and were excluded in this study. Lifelong anticoagulant therapy is continued for patency of the reconstructed IVC and HVs. The postoperative follow-up period averages 10.5 ± 6.7 years (range 0.2-28.1 years). Patients attended an outpatient clinic every 1 or 2 months for follow-up. Endoscopic examination for EV, enhanced computed tomography for patency of reconstructed IVC, and reopened HVs were evaluated every 1 or 2 years. We retrospectively analyzed a series of 59 patients (37 men; mean age, 46.8 ± 13.0 years; range, 21-73.3 years) who have all of the data of endoscopic findings of the esophagus and stomach. Of these 59 patients, 52 (88.1%) had EVs preoperatively. The number of preoperative patent HVs was 1.4 ± 0.8 per patient, and the pressure gradient across the obstructed site of the IVC was 12.9 ± 3.7 mm Hg. The pressure gradient across the reconstructed IVC markedly decreased and almost normalized to 4.8 ± 3.7 mm Hg from 12.9 ± 3.7 mm Hg. The patent HVs was increased to 2.5 ± 0.8 per patient from 1.4 ± 0.8 per patient. The endoscopic examination of EVs showed disappearance in 14 patients at discharge and in additional 12 patients in the late postoperative period. Our devised operative method could decrease portal pressure, which induces the disappearance of EVs not only in the early postoperative period but also in the late postoperative period." @default.
• W2346492362 created "2016-06-24" @default.
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• W2346492362 date "2015-06-01" @default.
• W2346492362 modified "2023-09-29" @default.
• W2346492362 title "PC184. Direct Approach for Correction of Budd-Chiari Syndrome (BCS): Verification of our Operative Method by the Postoperative Course of Esophageal Varices (EV)" @default.
• W2346492362 doi "https://doi.org/10.1016/j.jvs.2015.04.318" @default.
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