DIAGNOSIS AND TREATMENT OF PORTAL HYPERTENSION IN SECONDARY BILIARY CIRRHOSIS_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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Depaetment of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730;

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Secondary biliary cirrhosis Portal hypertension Diagnosis Treatment

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Objective To study the diagnosis and treatment of portal hypertension in secondary biliary cirrhosis(PHSBC). Methods Twenty-five cases of PHSBC within recent 16 years in our hospital were analyzed. Their clinical, pathological and follow-up data were reviewed retrospectively. They were divided into 4 groups according to their primary diseases:13 patients with hepatolithiasis, 6 with postoperative stricture of biliary duct, 4 with malignancy of biliary duct and 2 with others.
Results All patients were diagnosed clinically, and 4 were further pathologically confirmed. Eight cases were treated conservatively, while the remaining 17 underwent operations according to their primary diseases, and one combined with splenectomy and esophagogastric devascularization. The rate of discharge with improvement by surgical and non-surgical treatment was 64.7% and 37.5%, and hospital mortality was 17.6% and 12.5% respectively.
Conclusion The diagnosis of PHSBC mainly depends on its characteristic clinical manifestations. The early surgical resolution of bile duct obstruction is the key to good prognosis. If complicated with rupture and hemorrhage of oesophagofundal varices, the surgical procedure should be considered carefully.

Citation： LIN Guole GAO Weisheng,TANG Weisong,et al.. DIAGNOSIS AND TREATMENT OF PORTAL HYPERTENSION IN SECONDARY BILIARY CIRRHOSIS. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2001, 8(2): 95-97. doi: Copy

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5.	Tsutsumi M, Urashima S, Matsuda Y, et al. Changes in type Ⅳ collagen content in livers of patients with alcoholic liver disease [J]. Hepatology, 1993; 17(5)∶820.
6.	Zimmermann H, Reichen J, Zimmermann A, et al. Reversibility of secondary biliary fibrosis by biliodigestive anastomosis in the rat [J]. Gastroenterology, 1992; 103(2)∶579.
7.	黄洁夫，何晓顺，陈规划等. 原位肝移植治疗终末期肝病的临床体会 [J].中华器官移植杂志，1996； 17(2)∶60.
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1. Adson MA, Wychulis AR, Rochester JA. Portal hypertension in secondary biliary cirrhosis [J]. Arch Surg, 1968; 96(4)∶604.
2. 黄志强，蔡景修，韩本立等.胆管狭窄合并门脉高压的外科治疗问题 [J]. 中华外科杂志，1979； 17(5)∶321.
3. 胡国治，袁师拱，邱江锋等.肝胆管结石合并胆汁性肝硬变门脉高压症的手术方法与围手术期处理[J].中国普外基础与临床杂志，1999； 6(1)∶31.
4. Lakshmi MV, Sridharan GV, Butterworth D. Gallstone cirrhosis: are we only seeing the tip of the iceberg [J]? Br J Clin Pract, 1993; 47(3)∶164.
5. Tsutsumi M, Urashima S, Matsuda Y, et al. Changes in type Ⅳ collagen content in livers of patients with alcoholic liver disease [J]. Hepatology, 1993; 17(5)∶820.
6. Zimmermann H, Reichen J, Zimmermann A, et al. Reversibility of secondary biliary fibrosis by biliodigestive anastomosis in the rat [J]. Gastroenterology, 1992; 103(2)∶579.
7. 黄洁夫，何晓顺，陈规划等. 原位肝移植治疗终末期肝病的临床体会 [J].中华器官移植杂志，1996； 17(2)∶60.
8. Simmons TC. Distal common bile duct stricture and secondary biliary cirrhosis due to choledocholithiasis [J]. J Natl Med Assoc, 1991; 83(12)∶1105.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

DIAGNOSIS AND TREATMENT OF PORTAL HYPERTENSION IN SECONDARY BILIARY CIRRHOSIS

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