Long term outcomes of Budd-Chiari syndrome patients undergoing radical resection with full exposure of the inferior vena cava of the hepatic segmen

Objective To analyze the long-term curative effect of radical surgery for Budd-Chiari syndrome and the postoperative recurrence risk factors. Method Clinical data of 83 patients treated with radical surgery for Budd-Chiari syndrome through exposure of the entire inferior vena cava of the hepatic segment at Peking University People′s Hospital between Jul 2001 and Dec 2010 was studied. Survival rate, patency rate of the inferior vena cava and hepatic vein, and risk factors were analyzed. Results There were 5 perioperative deaths with a mortality rate of 6%. Child-Pugh C liver function (P=0.001) was independently related to the perioperative death. The mean follow-up time was 84±35(60-173)months. There were 8 patients (10.3%) lost to follow-up. 10 patients (12.8%) died during follow-up. Child-Pugh C liver function (P=0.003) was independently related to the follow-up death. 24 cases (40%) suffered from recurrence with inferior vena cava restenosis in 12 cases(20%), that of hepatic vein in 2 cases (3.3%), and 10 cases (16.7%)with both inferior vena cava and hepatic vein restenosis. Membranous lesion of inferior vena cava (P=0.004) and inadequate anticoagulation time (P=0.004) were independently related to the recrudescence. Conclusions Long term recurrence of Budd-Chiari syndrome after radical surgery through exposure of the entire inferior vena cava of the hepatic segment is related to membranous lesion of inferior vena cava and inadequate anticoagulation time. Key words: Budd-Chiari syndrome; Surgical procedures, operative; Survival rate; Recurrence rate; Risk factors