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학술저널
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소화기인터벤션의학회 International Journal of Gastrointestinal Intervention International Journal of Gastrointestinal Intervention 제8권 제2호
발행연도
2019.1
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74 - 81 (8page)

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Background: To compare the outcomes in a group of patients with Budd-Chiari syndrome (BCS) managed by percutaneous recanalization with a group of patients who were managed by medical therapy alone.Methods: We retrieved the hospital records of 37 patients with BCS admitted to our facility between 2004 to 2017 and identified 24 patients (male:female = 10:14; mean age, 32.7 ± 12.5 years) who underwent percutaneous recanalization. Remaining thirteen patients (male:female = 3:10; mean age, 36.77 ± 14.71 years), were managed by medical therapy. Technical and clinical results, complications, and primary patency of percutane-ous recanalization were analyzed. Overall and symptom-free survival rates, the frequency of symptom recurrence, and the number of readmissions for recurrent symptoms were analyzed in both interventional treatment and medical therapy groups.Results: Technical success for recanalization of hepatic vein/inferior venecava by angioplasty ± stenting was achieved in 22 patients (22/24, 91.7%). Clinical success was achieved in 19 patients (19/24, 79.2%). Overall survival for patients who underwent percutaneous recanalization at 1 year and five years was 87.0% and 87.0% and for patients with medical therapy was 90.1% and 45.5%, respectively (P = 0.710). Symptom-free survival for patients who underwent percutaneous recanalization at 1 year and five year was 93.3% and 81.7% and for patients with medical therapy was 26.0% and 0%, respectively (P < 0.001). In the intervention group, 4 patients (4/24, 16.7%) were admitted for recurrent symptoms (median number of read-missions 1, range: 1–2) whereas in medically managed patients 9 patients (9/13, 69.2%) were readmitted (median number of readmissions, 2; range, 1–5) (P = 0.003).Conclusion: There was no statistically significant difference in overall survival of patients managed with percutaneous recanalization and medical therapy. Percutaneous recanalization had definite benefit in terms of fewer recurrent symptoms and hospital admissions, hence should be performed whenever technically feasible.

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참고문헌 (23)

참고문헌 신청
Valla DC / 2009 / Primary Budd-Chiari syndrome / J Hepatol 50:195~203 google schola Valla DC / 2004 / Hepatic venous outflow tract obstruction etiopathogenesis: Asia versus the West / J Gastroenterol Hepatol 19:S204~S211 google schola Plessier A / 2006 / Aiming at minimal invasiveness as a therapeutic strategy for Budd-Chiari syndrome / Hepatology 44:1308~1316 google schola Qi XS / 2014 / Selection of treatment modalities for Budd-Chiari syndrome in China : a preliminary survey of published literature / World J Gastroenterol :10628~10636 google schola Darwish Murad S / 2004 / Determinants of survival and the effect of portosystemic shunting in patients with Budd-Chiari syndrome / Hepatology 39:500~508 google schola

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