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Management of severe Budd-Chiari syndrome: report of 147 cases.

BACKGROUND
Budd-Chiari syndrome (BCS) is an uncommon disorder caused by the obstruction of hepatic venous outflow and/or the inferior vena cava. Major therapeutic approaches include operation and radiological intervention. This study was conducted to investigate the treatment of severe BCS.


METHODS
The clinical data of 147 patients with severe BCS who had been treated at our hospital from November 1994 to December 2003 were retrospectively analyzed.


RESULTS
One hundred twenty-one patients with BCS underwent surgery, including mesocaval C type shunt with artificial graft (82 patients), splenojugular shunt (37), mesojugular shunt (2), percutaneous transhepatic recanalization and dilatation and/or stent placement of the main hepatic vein (MHV) (12), and combined percutaneous transhepatic angioplasty (PTA) and stent placement of the inferior vena cava and mesocaval shunt (14). Follow-up for 6-108 months showed excellent results in 102 patients (69.4%), good results in 40 (27.2%), and 5 deaths.


CONCLUSION
Good results could be obtained in most of patients with BCS after different surgical treatments according to the pathological changes of the IVC and MHV.