Combined devascularization and mesocaval shunt for treatment of portal hypertension: analysis of 100 cases / 中国实用外科杂志

ABSTRACT

ObjectiveTo study the hemodynamic changes in combined portoazygous devascularization and mesocaval shunt for treating portal hypertension and the effect of this operation. Methods100 cases of portal hypertension who received this combined operation from 1980 to 1995 were analyzed retrospectively. ResultsFree portal pressure(FPP)after shunt decreased to 1.92 kPa,which decreased portal pressure and preserved with (2.46 ± 0.30)kPa to maintain a good inflow to the liver and the encephalopathy rate was lowered. There was no death, and the effect was satisfactory. 5～15 years follow-up of 89 cases showed no rebleeding,with only 5% of encephalopathy and 15% of total mortality. Among them, 13 cases of Child C died of late-stage hepatopathy, such as liver failure, liver cancer and hepatorenal syndrome,with 94.5% of 5-year survival rate and 68.5% of 10-year survival rate. ConclusionThis combined operation is characterized by complete devascularization of sustaining varices and distal partial shunt with logical diameter. A perfect combination of both shunt and devascularization, it's one of the best choices currently available for treating portal hypertension in China.