portal decompression

The normal portal pressure is 110-180 mm water column. Because of various reasons, the portal blood flow is blocked. When the blood stagnates, the portal pressure rises, and a series of symptoms and signs of portal pressure increase appear, called portal hypertension. General surgical treatment, feasible portal decompression. Treatment of diseases: portal hypertension, portal hypertension Indication 1. Children with portal hypertension have repeated rupture of esophageal varices. 2. The general condition is good, and the liver function is in accordance with Child's grade A, B or portal hypertension. 3. The child is young, the splenic vein is fine or deformed, the spleen has been removed, and the thrombus formation in the portal vein is not suitable for spleno-renal venous shunt. Contraindications 1, with systemic diseases, can not tolerate surgery. 2, local infection, not suitable for surgery. 3, during the acute bleeding should be actively used non-surgical treatment to control bleeding, it is not appropriate to do intestinal-cavity shunt. 4, the general situation is poor, liver dysfunction, low protein, ascites. Preoperative preparation Antibiotics are routinely used before surgery. Surgical procedure 1. The child was placed in the supine position and underwent general anesthesia with endotracheal intubation. 2. Right rectus abdominis incision. After the abdomen, the superior mesenteric artery was touched along the middle cerebral artery, and a transverse incision was made at the root of the transverse mesenteric to expose the superior mesenteric artery. The superior mesenteric vein was found on the right side, and the length was 3 to 4 cm. 3. Cut the lateral peritoneum along the paracolic sulcus, free the ascending colon and cecum and push it to the left side, reveal the inferior vena cava and common iliac vein, cut off the lumbar vein and the right spermatic vein, and then the inferior vena cava and right The common iliac vein is free. 4. Measure the length from the left margin of the inferior vena cava to the superior mesenteric vein at the junction of the duodenum 2 and 3 segments. The position of the duodenum 2, 3 junction to the distal end of the inferior vena cava is determined according to its length, which is the position of the inferior vena cava or the common iliac vein. After selecting the position, the occlusion of the inferior vena cava was clamped with a vascular clamp, and the distal end of the measured distal vein was grasped with a heart clamp, and the portal vein or the common iliac vein was cut close to the heart ear pliers. 5. Continuous suture with a thin wire to close the distal inferior vena cava or the common iliac vein. 6. The inferior vena cava (orbital vein) was flexed with the superior mesenteric vein, and the inferior vena cava (the common iliac vein) was anastomosed to the superior mesenteric vein. 7. Place the drainage tube behind the retroperitoneum and poke it out. The abdomen was closed layer by layer. complication Edema.

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