患有慢性非循环外肝门静脉阻塞的患者的腹部手术:一个多中心的回顾性研究
Laure Elkrief1,2, Corentin Denecheau-Girard1, Marta Magaz3
1Faculté de médecine et service d'hépato-gastroentérologie, CHRU de Tours, ERN RARE-LIVER, France.
Hepatology (Baltimore, Md.)
|April 29, 2024
概括
患有肝外门静脉阻塞 (EHPVO) 的患者的腹部手术具有高出血和并发症的风险. 骨折和特定的外科手术类型增加了这些患者的不良结果.
科学领域:
- 血管外科 血管外科
- 胃肠病学 胃肠病学
- 外科手术的结果
背景情况:
- 在非肝硬化慢性肝外门静脉阻塞 (EHPVO) 中,关于手术性死亡率的数据有限.
- 肝外门静脉阻塞 (EHPVO) 对腹部手术提出了独特的挑战.
- 了解手术风险对于管理EHPVO患者至关重要.
研究的目的:
- 评估EPHVO患者的腹部手术相关的死亡率.
- 确定EPHVO患者手术后不良结果的危险因素.
- 为了比较EHPVO患者与对照者的手术结果.
主要方法:
- 76名EHPVO患者 (78次干预) 经过腹部手术后期分析.
- 将EHPVO患者与没有EHPVO的126名匹配对照患者进行比较.
- 评估主要出血,丁多-克拉维恩等级≥3并发症,门高血压相关并发症和死亡率.
主要成果:
- 37%的EHPVO患者经历了不利的结果 (严重出血,严重并发症或死亡).
- 炎和非壁/非胆囊切除干预与不良结果的增加有关.
- 与对照组相比,EHPVO患者的重大出血和门高血压相关并发症的发生率显著更高.
结论:
- 患有EHPVO的患者面临术前出血和术后并发症的风险增加.
- 特定的患者因素 () 和手术类型 (非壁,非胆囊切除术) 加大了这些风险.
- 风险分层对于优化EHPVO手术管理至关重要.
相关概念视频
Esophageal Varices-I: Introduction
117
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
117
Esophageal Varices-II: Clinical Features and Management
60
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
60


