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Objective To investigate the clinical effect of vagus nerve preserving pericardial devascularization plus subtotal splenectomy in treating portal hypertension with a history of variceal bleeding.Methods The clinical data of 33 cases of portal hypertension with variceal hemorrhage treated with vagus nerve preserving selective pericardial devascularization plus subtotal splenectomy from April 2004 to December 2013 (study group) were compared with that of 34 cases treated with pericardial devascularization plus splenectomy (control group).Results There was no mortality in two groups.The postoperative gastric drainage during the first 72 h were(1 525 ±30) ml in the study group and (2 130 ±40) ml in control group(P ＜0.05).Portal vein thrombosis developed in one case in the study group and 15 cases in the control group(P ＜ 0.05).Postoperative 3-year recurrent gastroesophageal varices hemorrhage was 15％ in the study group and 25％ in the control group (P ＜ 0.05).Postoperative 5-year variceal hemorrhage recurrence rate were 28％ in the study group and 30％ in the control group (P ＞ 0.05).Conclusions Maitaining vagus nerve selective pericardial devascularization plus subtotal splenectomy is of less postoperative complication and lower portal vein thrombosis rate and better patients' survival compared with pericardial devascularizatim plus total splenectomy.
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0.05), and both groups got ideal clinical effect. Conclusions MGHSV is an ideal operation for various types of duodenal ulcer, which with a preferable long-term effect. It is worth to be widely applied in clinical practice.
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Objective To evaluate the long-term results of extended parietal cell vagotomy (EPCV) for the treatment of acutely perforated duodenal ulcer. Methods EPCV was performed on 239 patients. Results were analyzed retrospectively. Results Follow up was made on 203 out of 239 patients (84.9%). There was no operative mortality. Inhospital complications included injury to the spleen in 4 cases (1.7%), adhesive ileus in 6(2.5%), acute diarrhea in 3 (1.3%), and postprandial epigastric distention in 18 (7.5%). Long-term complications included epigastric pain and sour regurgitation in 16 cases(7.8%), enterolysis in 4(1.9%), duodenal bulb allaxis in 39(18.2%), chronic gastritis in 21(10.3%), and recurrent ulcer in 6(2.9%). Basic acid output, maximal acid output and peak acid output decreased by 84.7%, 60.0%, and 58.0% respectively(all P