摘要
根据Ｓｕｇｉｕｒａ术的血流动力学原理．将Ｗａｌｋｅｒ术进行改良，用来治疗门静脉高压症术后再出血．特点是在食道下段较低位量阻断食道静脉血流的同时，又可离断腹段残留或复发的冠状静脉属支．优点是经胸手术回避了前次手术粘连和血管栓塞等矛盾．手术简单省时，适应症宽，近期止血可靠、远期效果良好。本组手术１９例，均为各种手术后再出血者．择期手术１５例无死亡；急症手术４例，死亡１例．总的手术死亡率５．２６％（１／１９）．再手术后的生存时间：９ａ１例，７ａ２例，６ａ１例，４ａ３例，３ａ６例．２ａ３例，１ａ１例．
Modified Walker's operation devised according to the hemodynamic principle of Sugiura's operation was employed in the treatment of postoperative rebleeding of portal hypertension. The distinct feature of this operation is to interrupt blood flow of esophageal. veins at rather lower site of distal segment of esophagus and mean time can disconnect residues of abdominal segment or recurred variceal branches of coronary vein. Besides, it avoids to encounter troublesome adhesions and vascular thrombosis of previous operation. Modified Walker's operation is simple, time-saving, with broad indications,reliable immediate hemostatic effect and good remote postoperative results. This series consists of 19 cases of postoperative rebleeding after different kinds of operations.15 cases of elective operation were without mortality while 4 cases of emergency operation with one died after operation. Total operative mortality was 5. 26%(1/19). The survival times after reoperation were: 9 a(1case) ; 7 a(2 cases): 6 a(1 case); 4 a(3 cases) ; 3 a (6 cases) ; 2 a (3 cases) and 1a(1case ).
出处
《肝胆外科杂志》
1994年第3期143-145,共3页
Journal of Hepatobiliary Surgery
关键词
门脉高血压
出血
断流术
分流术
portal hypertension
transthoracic esophageal transection
rebleeding
