Compensation by collateral circulation determines invasive therapeutic indications for patients with Budd-Chiari syndrome
- 1Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, School of Medicine, Institute of Hepatobiliary and Pancreatic Diseases, Zhengzhou University, Zhengzhou, P. R. China
- 2Department of Radiological Intervention, The First Affiliated Hospital of Zhengzhou University, School of Medicine, Zhengzhou, P. R. China.
- Correspondence to Dr Yuling Sun, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, School of Medicine, Institute of Hepatobiliary and Pancreatic Diseases, Zhengzhou University, 1 Jianshe Road, Zhengzhou 450052, P.R. China; ylsun{at}zzu.edu.cn
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Contributors YS and XM: conception and design, collection and assembly of data, data analysis and interpretation, manuscript writing, final approval of the manuscript; LF: data interpretation and manuscript revision; SG and ZW: collection and assembly of data, data analysis and interpretation.
- Accepted 3 May 2012
- Published Online First 11 June 2012
- Budd-Chiari syndrome
- collateral circulation
- therapeutic indication
- hepatobiliary surgery
- portal hypertension
We read with interest the comprehensive review article by Rössle and Gerbes that details the management of ascites in patients with liver cirrhosis and concludes that the transjugular intrahepatic portosystemic shunt (TIPS) could manage refractory ascites more effectively than large-volume paracentesis.1 However, there is an important issue regarding the management of ascites, which is caused by Budd-Chiari syndrome (B-CS), that the authors failed to address.
In patients with chronic course, the formation of intra and extrahepatic collaterals leads to improvement of liver function and may silence this disease and make it asymptomatic.2 Thus, collateral circulation …
