Clinical significance of large spontaneous portosystemic shunts in Budd-Chiari syndrome / 中华普通外科杂志

ABSTRACT

Objective To explore the clinical significance of large spontaneous portosystemic shunts (L-SPSS) in Budd-Chiari syndrome (B-CS).Methods Clinical data of 382 B-CS patients treated at the First Affiliated Hospital of Zhengzhou University from Apr 2012 to Dec 2018 were analyzed retrospectively and we included 32 patients with B-CS complicated L-SPSS (diameter ＞ 8 mm).65 patients without L-SPSS were selected randomly to form the control group.The correlation between L-SPSS and liver function,upper gastrointestinal bleeding,ascites,hepatic encephalopathy,inferior vena cava thrombosis,portal vein diameter and splenic vein diameter were analyzed.Results TBil,Child-Pugh scores,incidence of hepatic encephalopathy,ascites and inferior vena cava thrombosis in the B-CS complicated L-SPSS group were higher than that in the B-CS without L-SPSS group.The percentage of Child-Pugh grade B and C patients in the B-CS complicated L-SPSS group were also higher than that in the B-CS without L-SPSS group.The level of ALB and hepatic volume per unit surface area were both significantly less in the experimental group.(P ＜0.05).There were no statistics differences in incidence of upper gastrointestinal bleeding and MELD scores between the two groups (P ＞ 0.05).Conclusions For those B-CS patients complicated L-SPSS,hepatic encephalopathy and ascites are more frequent,and they usually have poorer liver function.