[Staged surgery in the treatment of Budd-Chiari's syndrome of mixed type]

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Hepatology

Context:

• Budd-Chiari syndrome is a rare condition causing hepatic vein obstruction.
• Mixed-type Budd-Chiari syndrome presents complex challenges for surgical management.
• Previous treatments have varying success rates and complications.

Purpose:

• To assess the efficacy of combined surgical strategies for mixed-type Budd-Chiari syndrome.
• To compare outcomes of different initial interventions followed by shunt procedures.
• To evaluate long-term results of these combined approaches.

Summary:

• Nine patients with mixed-type Budd-Chiari syndrome underwent surgical treatment.
• Three patients received balloon angioplasty followed by shunt surgery (Hassab's and Linton's procedures).
• Two patients underwent IVC incision and plasty, followed by shunt surgery.
• Four patients had prehepatic cavoatrial shunt, followed by shunt surgery.
• Follow-up ranged from 6 to 24 months, with satisfactory results reported for all patients.

Impact:

• Demonstrates the effectiveness of staged surgical interventions for complex Budd-Chiari syndrome.
• Highlights the potential of combining angioplasty or IVC plasty with shunt procedures.
• Provides evidence for improved patient outcomes in managing this challenging vascular condition.