A Novel Approach with Supra- and Retro-hepatic Cavocaval Bypass for Short Segmental Occlusion of Inferior Vena Cava in Budd-Chiari Syndrome
Bibliographic record
Abstract
BACKGROUND: Budd-Chiari syndrome (BCS) is defined as chronic, progressive and congestive liver dysfunction resulting from obstruction of the outflow of inferior vena cava (IVC) and/or hepatic veins. One of the common types of BCS is short segmental occlusion of retrohepatic IVC (SSOR-IVC) accompanied by varied extent of obstruction of intrahepatic veins. The mainstay of surgical treatment at present for SSOR-IVC is cavoartrial bypass via thoracolaparotomic approach, in which thoracic and pulmonary complications intra- and/or post-operation are common. We have developed an abdominal approach using suprahepatic and retrohepatic inferior vena cavocaval bypass to treat SSOR-IVC, herein we compared it with the conventional thoracolaparotomic approach. METHODS: From 2005 to 2008, we performed suprahepatic and retrohepatic inferior vena cavocaval bypass using artificial vessel in 16 BCS patients with SSOR-IVC (group A), we compared the results of this new modality with that using traditional thoracolaparotomic approach in 18 patients (group B) from 2001 to 2004. RESULTS: In group A, one patient had intraoperative acute cardiac failure due to rapid opening of the bypassed vessel, and the symptom was resolved immediately through prompt management, while the others were not eventful during or post-operation. The length of artificial vessel required was 6 to 8 cm, and all patients had no graft vessel thrombosis after 10 to 55 months follow-up. In group B, one patient had intraoperative acute pericardial tamponment due to anastomotic leakage. The total occurrence rate of postoperative complication was 27.8%, including three pleural effusions, one pulmonary infection and one acute pericarditis. The length of the artificial vessel required was 12 to 14 cm. Three patients had graft vessel thrombosis at 37, 42 and 58 months post-operation, respectively. CONCLUSIONS: The abdominal approach for suprahepatic and retrohepatic cavocaval bypass have advantages as follows over the traditional thoracolaparotomic approach for cavoartrial bypass: 1) Less traumatic with fewer postoperative thoracic and pulmonary complications; 2) A shorter artificial vessel required to facilitate endothelial seeding for improved long term patency; 3) Void of risk of fatal pericardial tamponment; 4) Prevention of acute pericarditis due to pericardial irritation by the artificial vessel in the thoracolaparotomic approach. We concluded that this novel abdominal approach is a safe and effective technique for treatment of SSOR-IVC.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".