12只猫肝内门体分流的外科治疗和转归

期号：Vol 24, Issue 10, July 14, 2022

作者：Lavinia Economu，Rhiannon Strickland，Vicky J Lipscomb

摘要来源：

https://doi.org/10.1177/1098612X221109325

译员：林飞

一校：郭嘉恩

二校：朵曜腾

编辑：百可事乐

摘要

本病例系列的目的是描述12只猫先天性肝内门体分流（intrahepatic portosystemic shunt ，IHPSS）的临床表现、手术治疗和转归。对因IHPSS接受外科治疗的猫进行了回顾性病例系列研究。通过医疗记录获取病例的基本信息、临床症状、影像学结果、手术疗法、并发症和短期转归（<30天）。在可能的情况下，通过宠主问卷调查健康相关的生活质量，以获取长期转归（>首次手术后1年）。通过术中肠系膜门静脉造影，诊断7只猫为左侧分流，3只猫为中央分流，2只猫为右侧分流。3只猫进行了完全直接缝线结扎，8只猫进行了部分缝线结扎减流（其中4只猫在第二次手术时进行了完全缝线结扎），1只猫用薄膜带进行了部分结扎减流。6只猫（50%）在第一次手术后出现门脉缩窄术后神经症状（post-attenuation neurological signs，PANS），2只猫（17%）因严重PANS死亡或被安乐死。可获得8只猫（67%）的长期结果信息，中位随访时间为1743天（364–2228天），5只猫（63%）转归极好，2只猫（25%）转归一般，1只猫（12%）转归差。

很少有论文描述猫IHPSS的临床表现、术中成像、治疗和转归。这是第一次在患有IHPSS的猫上用薄膜带进行手术结扎减流的报道。本病例系列报告了大多数接受IHPSS手术治疗的猫具有极好的长期转归。

原文：

Surgical treatment and outcome of intrahepatic shunts in 12 cats

Lavinia Economu，Rhiannon Strickland，Vicky J Lipscomb

https://doi.org/10.1177/1098612X221109325

Abstract

Case series summary

The objective of this case series was to describe the presentation, surgical treatment and outcome of a congenital intrahepatic portosystemic shunt (IHPSS) in 12 cats. A retrospective case series of cats undergoing surgical treatment for an IHPSS was undertaken. Signalment, clinical signs, imaging, surgical treatment, complications and short-term outcome (<30 days) were obtained using medical records. Long-term outcome (>1 year after first surgery) was obtained, where possible, using a health-related quality of life owner questionnaire. Seven cats were diagnosed with a left divisional shunt, three with a central divisional shunt and two with a right divisional shunt using intraoperative mesenteric portovenography. Three cats tolerated complete acute suture attenuation, eight cats underwent partial suture attenuation, four of which received complete suture ligation at a second surgery, and one cat underwent partial attenuation with a thin film band. Six cats (50%) developed post-attenuation neurological signs (PANS) after first surgery and two cats (17%) died or were euthanased due to severe PANS. Long-term outcome was available for eight cats (67%), with a median follow-up time of 1743 days (range 364–2228), and was described as excellent in five cats (63%), fair in two cats (25%) and poor in one cat (12%).

Relevance and novel information

Few papers exist that describe the presentation, intraoperative imaging, treatment and outcome of IHPSSs in cats. This is the first to describe surgical attenuation with a thin film band in a cat with an IHPSS. This case series reports excellent long-term outcomes in a majority of surgically treated cats with IHPSS.