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Reestablishment of second hepatic hilum――a new technique for the treatment of Budd－Chiari syndrome
杨建勇 张翎 余深平 陈伟 庄文权 冯敢生* 梁惠民*
YANG Jianyong，ZHANG Ling，YU Shenping，CHEN Wei，ZHUANG Wenquan 庄文权，FENG Gansheng* and LIANG Huimin* .
中山医科大学附属第一医院放射科，广州，510080
Department of Radiology，the First Affiliated Hospital of Sun Yat－Sen University of Medical Sciences，Guangzhou 510080，China （Yang JY，Zhang L，Yu SP，Chen W，Zhuang WQ，Feng GS and Liang HM）
*华中科技大学同济医学院附属协和医院，武汉，430022
*the Department of Radiology，Xiehe Hospital，Tongji Medical College，Huazhong University of Sciences and Technology，Wuhan
Objective：We introduced a new interventional technique of reestablishing the second hepatic hilum by means of puncturing and stenting the liver tissue between the intrahepatic vena cava and a hepatic vein，for the treatment of Budd－Chiari Syndrome （BCS）
Methods：Two patients with BCS，in which no second hepatic hilum structure was found in transhepatic venography，underwent an interventional procedure of canalizing and stenting the parenchyma－tract between the intrahepatic vena cava and a hepatic vein. The procedures were performed in percutaneous transhepatic and right jugular vein approach respectively. Metallic stent with 10－mm diameter was implanted to maintain the tract patency.
Results：The free hepatic vein pressure （FHVP） were decreased from 37mmHg to 5mmHg and from 28mmHg to 4mmHg respectively after the procedure. The complication of hemorrhage due to puncture was observed in one patient. Those 2 patients went quit well in 3－year follow－up. Both clinical conditions and laboratory values were significantly improved after the procedure. And the stented canals （the reestablished second hepatic hilum） maintained patent with normal FHVP，which was confirmed in the control venography. | 
