{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T07:39:40Z","timestamp":1758267580887},"reference-count":0,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[1998,1,1]],"date-time":"1998-01-01T00:00:00Z","timestamp":883612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1998,1]]},"abstract":"Abstract<\/jats:title>Budd\u2010Chiari syndrome (BCS) is an uncommon form of portal hypertension caused by obstruction of the hepatic venous outflow. From 1969 to 1997 we treated 19 patients (7\u00a0men, 12 women; mean age 37.6 years) affected by primary BCS. In most of the cases no etiologic factors were identified; in the remaining cases the etiology was associated with polycythemia vera, use of oral contraceptives, presence of endoluminal membranes, and repeated episodes of sepsis. Three patients with membranous occlusion of the major hepatic veins were treated by percutaneous placement of a self\u2010expanding metallic stent inserted via a transjugular or transhepatic approach. The remaining 16 patients underwent a side\u2010to\u2010side portacaval shunt, which required interposition of a graft in five cases. In two patients with a significant caval obstruction, a metallic vascular stent was placed in the narrowed tract of the inferior vena cava, before shunting, by means of a transfemoral venous approach. One patient died within the first 30 postoperative days. The 18 survivors were followed for a mean of 66.7\u00a0months. The 5\u2010year survival was 83%. Primary BCS requires different therapies depending on the stage of the disease. The fulminant or chronic forms with irreversible hepatic damage require definitive treatment, such as orthotopic liver transplantation. For the acute or subacute forms, characterized by reversible hepatic injury, a portasystemic shunt represents the most effective treatment. The patients at poor hepatic risk can be treated by interventional radiology. In both cases preliminary caval stenting is necessary if the syndrome is complicated by significant obstruction of the inferior vena cava.<\/jats:p>","DOI":"10.1007\/s002689900348","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T05:57:49Z","timestamp":1030255069000},"page":"48-54","source":"Crossref","is-referenced-by-count":28,"title":["Surgical and Radiologic Treatment of Primary Budd\u2010Chiari Syndrome"],"prefix":"10.1002","volume":"22","author":[{"given":"Andrea","family":"Pisani\u2010Ceretti","sequence":"first","affiliation":[{"name":"Second Divisione di Chirurgia Generale Ospedale Fatebenefratelli e Oftalmico 23 Corso di Porta Nuova 20121 Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattia","family":"Intra","sequence":"additional","affiliation":[{"name":"Second Divisione di Chirurgia Generale Ospedale Fatebenefratelli e Oftalmico 23 Corso di Porta Nuova 20121 Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Prestipino","sequence":"additional","affiliation":[{"name":"Second Divisione di Chirurgia Generale Ospedale Fatebenefratelli e Oftalmico 23 Corso di Porta Nuova 20121 Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Ballarini","sequence":"additional","affiliation":[{"name":"Second Divisione di Chirurgia Generale Ospedale Fatebenefratelli e Oftalmico 23 Corso di Porta Nuova 20121 Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Cordovana","sequence":"additional","affiliation":[{"name":"Second Divisione di Chirurgia Generale Ospedale Fatebenefratelli e Oftalmico 23 Corso di Porta Nuova 20121 Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Santambrogio","sequence":"additional","affiliation":[{"name":"Sixth Clinica Chirurgica Istituto di Scienze Biomediche, Ospedale San Paolo, Universit\u00e0 di Milan Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Paolo","family":"Spina","sequence":"additional","affiliation":[{"name":"Second Divisione di Chirurgia Generale Ospedale Fatebenefratelli e Oftalmico 23 Corso di Porta Nuova 20121 Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1998,1]]},"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s002689900348.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s002689900348\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s002689900348","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T16:36:50Z","timestamp":1703695010000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s002689900348"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,1]]},"references-count":0,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1998,1]]}},"alternative-id":["10.1007\/s002689900348"],"URL":"https:\/\/doi.org\/10.1007\/s002689900348","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,1]]}}}