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Radical open endvenectomy with autologous pericardial patch graft for correction of Budd-Chiari syndrome
K Koja1, A Kusaba, Y Kuniyoshi
1Second Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
Insights
A novel surgical approach effectively reconstructs the vena cava and hepatic veins for Budd-Chiari syndrome. This technique offers good patient outcomes and symptom relief for vena caval obstruction.
Area of Science:
- Vascular Surgery
- Hepatology
- Interventional Radiology
Background:
- Budd-Chiari syndrome involves hepatic vein or inferior vena cava obstruction.
- Vena caval obstruction leads to portal hypertension and liver damage.
- Surgical interventions are critical for managing severe cases.
Purpose of the Study:
- To present a surgical technique for Budd-Chiari syndrome with vena caval obstruction.
- To evaluate the efficacy of open endvenectomy with autologous pericardial patch graft and femorofemoral bypass.
- To assess outcomes in patients with complex venous reconstructions.
Main Methods:
- Open endvenectomy for occluded hepatic vena cava and hepatic veins.
- Use of autologous pericardial patch graft for reconstruction.
- Femorofemoral bypass technique employed during surgery.
- Hepatic artery and portal vein were not clamped.
Main Results:
- Successful reconstruction in 29 patients between 1979 and 1994.
- Good function of reconstructed vena cava and hepatic veins observed.
- Acceptable reduction in symptoms of portal hypertension and caval stagnation.
- All patients demonstrated positive outcomes.
Conclusions:
- This surgical technique provides a viable treatment for Budd-Chiari syndrome.
- The method ensures good long-term patency of venous reconstructions.
- It effectively alleviates symptoms associated with venous obstruction.
Abstract:
A surgical technique for the treatment of Budd-Chiari syndrome associated with vena caval obstruction has been devised. The occluded hepatic vena cava and hepatic veins were reconstructed by open endvenectomy, using an autologous pericardial patch graft and a femorofemoral bypass technique. The hepatic artery and portal vein were not controlled with vascular clamps during the surgery. Between 1979 and 1994, 29 patients were treated using this technique and achieved good results. All the patients did well with good function of the reconstructed vena cava and of the hepatic veins, and showed acceptable reduction of symptoms caused by portal hypertension and caval stagnation.