Endovascular treatment of Budd-Chiari syndrome / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Budd-Chiari syndrome (BCS) is a posthepatic portal hypertension caused by the obstruction of the lumen of the hepatic veins or the proximal inferior vena cava (IVC). This study aimed to evaluate the clinical experience of interventional therapy for Budd-Chiari syndrome.</p><p><b>METHODS</b>IVC venography was carried out first, the obliteration or stenosis in the IVC was opened or dilated with the hard guided wire or Rups100 puncture needle and balloon, then a stent was routinely implanted for the type of obliteration or stenosis.</p><p><b>RESULTS</b>The procedure was successful in 821 out of 903 cases including IVC intervention in 760 cases, and hepatic vein intervention in 61 cases. An IVC stent was used in 517 cases and hepatic vein stent in 19 cases. There were no pulmonary embolisms, but acute renal failure occurred in eight cases, hepatic coma in two cases and acute heart failure in 43 cases. Two patients died in this group and five cases were complicated with acute IVC thrombosis. Follow up of 7 to 124 months was made in 679 cases with recurrence found in 59 cases.</p><p><b>CONCLUSIONS</b>Interventional therapy is safe and effective with a fast recovery for most types of BCS. It is gradually becoming the first therapeutic choice.</p>

Treatment of severe acute biliary pancreatitis in the elderly by integrated traditional Chinese and Western medicine / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To summarize the therapeutic effect of integrated traditional Chinese and Western medicine (ICWM) on severe acute biliary pancreatitis (SABP), and to discuss the opportunity of operation.</p><p><b>METHODS</b>The hospitalization duration, incidence of complications, operation transmitting rate and mortality were analyzed in 96 senile SABP patients (Group A) treated by ICWM, and 32 senile SABP patients treated by conventional Western medicine, they were hospitalized from January 2000 to December 2007.</p><p><b>RESULTS</b>(1) The average hospitalization duration in Group A and B was 28.2 +/- 11.3 days and 32.7 +/- 14.3 days respectively, showing insignificant difference between them (P>0.05); (2) The early stage incidence of complications being 29.2% (28/96) in Group A and 34.4% (11/32) in Group B, no significant difference between groups was shown, but a significant difference did show at the late stage, 36.5% (35/96) vs 53.1% (17/32), the incidence in Group A was lower significantly (P<0.05). (3) The two groups were not different in operation transmitting rate 36.4% (35/96) vs 43.8% (14/32), P>0.05. (4) The mortality in Group A, 21.9% (21/96) was lower than that in Group B, 37.5% (12/32), P <0.05.</p><p><b>CONCLUSION</b>ICWM has good effect in treating SABP, and the opportunity of operation transmitting should be decided according to whether there obstruction of biliary tract exists or not.</p>