Is There Still a Role for Surgical Shunts in the Treatment of Budd-Chiari Syndrome? A 25-Year Experience

Serin K. R., Tekant Y., Emre A.

JOURNAL OF GASTROINTESTINAL SURGERY, cilt.24, sa.6, ss.1359-1365, 2020 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 24 Sayı: 6
  • Basım Tarihi: 2020
  • Doi Numarası: 10.1007/s11605-020-04524-7
  • Dergi Adı: JOURNAL OF GASTROINTESTINAL SURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.1359-1365
  • İstanbul Üniversitesi Adresli: Evet

Özet

Purpose To investigate the long-term results of shunt surgery in the treatment of Budd-Chiari Syndrome. Methods Medical records of patients treated with Budd-Chiari Syndrome between 1993 and 2006 were reviewed. Results Thirty-seven patients (26 female, 11 male) were identified, with a median age of 30 years (range 14-51). Median duration of symptoms was 3 months (range 1 month to 10 years). Twenty-five patients, all in acute or subacute stages of disease, were treated surgically. Constructed shunts were mesoatrial in 17, portocaval in five (one was converted from a failed portorenal shunt) and mesocaval in three. Median portal pressure decreased from 44 cm H2O (range 31-55) to 20 cm H2O (range 5-27). Seven patients (28%) died in the perioperative period. Eighteen patients (72%) were followed up for a median of 186 months (24-241 months). Seven patients died during follow-up, five due to reasons related to the underlying cause and treatment. Remaining 11 patients (61%) were alive at a median of 18 years (13-25 years) with patent shunts. One-, 5-, and 10-year survival rates in patients undergoing shunt surgery were 78%, 72%, and 66%, respectively. Conclusion Portosystemic shunts may still be considered when expertise for transjugular intrahepatic portosystemic shunt or liver transplantation is not available.