Cavo-meso-atrial shunt for the treatment of Budd-Chiari syndrome due to combined occlusion of inferior vena cava and hepatic vein / 中国普通外科杂志

ABSTRACT

Objective To investigate the efficacy of cavo-meso-atrial shunt for the treatment of Budd-Chiari syndrome (BCS) with occlusion of both inferior vena cava (IVC) and hepatic veins (HVs) lesions. Method 14 cases with BCS due to combined occlusion of IVC and HVs were treated from 1996. 8 cases were male and 6 cases female.The age ranged from 20 to 36 years old. HVs occlusion with complete IVC occlusion was found in 12 cases and stenosis of IVC in 2 cases. Cavo-meso-atrial shunt was performed. Result There was no perioperative death. Thrombosis of graft occurred in two cases, one died of upper digestive tract bleeding and hepatic coma half year post-operation. The mortality rate at follow-up period was 7%, the total patency of graft was 86% and the patency of cavo-atrial graft was 93%. The decrease in portal vein pressure was between 5 to 26 cmH 2O with an average of 15.5 cmH 2O. No serious complications occurred. Conclusion The cavo-meso-atrial graft shunt is an alternative to treat patients with occlusion of both IVC and HVs due to IVC thrombosis. The long term patency remains to be evaluated.