Surgical treatment of Budd-Chiari syndrome

被引:30
作者
Klein, AS [1 ]
Molmenti, EP [1 ]
机构
[1] Johns Hopkins Univ, Dept Surg, Div Transplantat, Baltimore, MD USA
关键词
D O I
10.1053/jlts.2003.50156
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Shunting and transplantation are satisfactory methods of treating Budd-Chiari syndrome (BCS). Selection of treatment is based on the degree of hepatic injury (clinical settings), liver biopsy results, potential for parenchymal recovery, and pressure measurements. Shunting is recommended in cases of preserved hepatic function and architecture. In the presence of fulminant forms of BCS, in cases of established cirrhosis or frank fibrosis, or for patients with defined hepatic metabolic defects (e.g., protein C or protein S deficiency), liver transplantation is the treatment of choice. Nonsurgical alternatives, although encouraging, have limited long-term outcome results at the present time. In most cases of BCS, a thrombophilic disorder can be identified. However, it is important to note that postoperative vascular thrombosis has been identified in patients with BCS who do not have a definable hypercoagulable predisposition. It therefore is our practice to recommend early (<24 hours postoperatively) initiation of intravenous heparin therapy in all patients with BCS, who then undergo life-long anticoagulation with coumadin.
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收藏
页码:891 / 896
页数:6
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