Diagnosis and surgical treatment of adult cavernous transformation of portal vein in 63 cases / 中华肝胆外科杂志

ABSTRACT

Objective To summarize the diagnosis and surgical treatment of the cavernous transformation of portal vein (CTPV). Methods Clinical data of 63 patients with adult CTPV trea-ted in our hospital from 1976 to 2006 were retrospectively analyzed. Results The diagnosis of CT-PV was comfirmed according to (1) The main symptoms were repeated haematemesis, hemafecia, hy-persplenotrophy, hypersplenia and normal hepatic function. (2) B uhrasonography or ultrasonic Doppler manifested that portal vein thinning or obstruction or embolism, honeycomb appearance con-duit can be seen around. Portal vein frequency spectrum can be seen in the honeycomb appearance con-duit. (3) CT and MR scan materials were exhibited that the main portal vein and its branches lost the normal shape and had the shaggy edge. (4) percutaneous splenoportography or selective arteriography of superior mesenteric artery showed that occlusion of the main branch of portal vein at the porta hepa-tis was revealed, and a masslike network of tortuose veins around the porta hepatis and many small ir-regular veins radiating from the network to the liver were demonst rated. Splenectomy and devaseu-larization was performed in 23, spleneetomy and splenorenal shunt in 32, portal systemic shunt plus porta-azygous devascularization in 8. Portal hypertension was treated first in CTPV with disease of biliary tract. No death happened. The rascult of haemogram recovered in a short period of time.Conclusion Once the patients are diagnosed to suffer from adult CTPV, they should receive explora-tory laparotomy. It is important to choose the most effective treating method for the disease.