Surgical management of the Budd‐Chiari syndrome: No place for a procrustean bed

Alan Norman Langnas, Michael Floyd Sorrell, Jeremiah P. Donovan, Byers W. Shaw

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Over 12 years, 22 patients with the Budd‐Chiari syndrome were treated surgically. Eighteen underwent a mesenterico‐caval shunt (MCS); two, a side‐to‐side portacaval shunt; one, a mesentericoatrial shunt (MAS); and one, a liver transplantation (OLT). One patient died after operation from the precipitating condition, and two MCS grafts that thrombosed were restored. All 21 surviving patients remain well, free from ascites, and all shunts are patent after a mean follow‐up of 5.6 ± 1 years, five patients with more than 10 years' follow‐up. This long‐term survival achieved by portasystemic shunts suggests that they have a major role in the treatment of the Budd‐Chiari syndrome. The authors prefer the mesenterico‐caval shunt using a jugular graft. This ensures a total portasystemic shunt, avoids subhepatic surgery, and reduces the long‐term risk of prosthetic graft thrombosis. The MAS was reserved for cases with complete caval thrombosis. Patients with significant degrees of caval compression were satisfactorily decompressed by MCS. In patients not promptly treated, the disease progresses to cirrhosis and such patients must be evaluated for transplantation similarly to those with other hepatopathies.

Original languageEnglish (US)
Pages (from-to)1303-1305
Number of pages3
JournalHepatology
Volume16
Issue number5
DOIs
StatePublished - Nov 1992

Fingerprint

Surgical Portasystemic Shunt
Venae Cavae
Thrombosis
Transplants
Surgical Portacaval Shunt
Ascites
Liver Transplantation
Fibrosis
Neck
Transplantation
Survival
Therapeutics

ASJC Scopus subject areas

  • Hepatology

Cite this

Surgical management of the Budd‐Chiari syndrome : No place for a procrustean bed. / Langnas, Alan Norman; Sorrell, Michael Floyd; Donovan, Jeremiah P.; Shaw, Byers W.

In: Hepatology, Vol. 16, No. 5, 11.1992, p. 1303-1305.

Research output: Contribution to journalArticle

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