Document Detail


Experience with mesocaval shunt with autologous jugular vein interposition in patients with Budd-Chiari syndrome.
MedLine Citation:
PMID:  15966177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: In the present era of interventional radiology and liver transplantation, the role of mesocaval shunt surgery for portal hypertension in Budd-Chiari syndrome is reviewed. METHODOLOGY: This study analyzed the management of 35 patients with Budd-Chiari syndrome between June 1994 and June 2004 in our institution. During this 10-year interval, 31 of the 35 patients with Budd-Chiari syndrome underwent shunt procedures and four patients underwent liver transplantation. Mesocaval shunts were preferred in 27 patients and seven of these patients required prior caval stenting. One portocaval shunt was performed in a patient having a thrombosed mesocaval shunt. In all mesoaval shunt procedures the patient's internal jugular vein was used as an interposition graft between the superior mesenteric vein and inferior vena cava. In four patients with thrombosed vena cava a mesoatrial shunt was performed using polytetrafluoroethylene graft while four patients with established cirrhosis underwent orthotopic liver transplantation. RESULTS: In the group of mesocaval shunts, 3 patients were lost in the early postoperative period with a mortality rate of 11%, 2 of them due to thrombosed shunts and one of them due to pneumonia. The median follow-up was 42 months (6-120 months) and one patient experienced shunt thrombosis and died afterwards due to the complications of portal hypertension. In the whole series the patency rate of the mesocaval shunt was 89%. CONCLUSIONS: Patients with Budd-Chiari syndrome can be managed by a combination o f shuntsurgery, interventional radiology and liver transplantation. Our results demonstrate the effectiveness of mesocaval shunt procedure with autologous jugular vein interposition to maintain long-term patency and survival.
Authors:
Ozer Ilkgul; Murat Kilic; Gökhan Içöz; Murat Zeytunlu; Gulgun Demirpolat; Mahir Akyildiz; Yaman Tokat; Mustafa Parildar; Ahmet Memis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  52     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2005 May-Jun
Date Detail:
Created Date:  2005-06-21     Completed Date:  2005-12-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  662-5     Citation Subset:  IM    
Affiliation:
General Surgery Department, Celal Bayar University, School of Medicine, Manisa, Turkey. ilkgul@doctor.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Anastomosis, Surgical*
Budd-Chiari Syndrome / diagnosis,  etiology,  surgery*
Female
Graft Occlusion, Vascular / diagnosis,  therapy
Humans
Hypertension, Portal / diagnosis,  etiology,  surgery
Jugular Veins / transplantation*
Liver Function Tests
Liver Transplantation
Magnetic Resonance Angiography
Male
Mesenteric Veins / surgery*
Middle Aged
Postoperative Complications / diagnosis,  therapy
Radiology, Interventional
Stents
Ultrasonography, Doppler, Duplex
Vena Cava, Inferior / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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