Long-term result of combined splenorenal shunt plus portaazygous devascularization in the treatment of bleeding esophageal varices in patients of portal hypertension / 中国普通外科杂志

ABSTRACT

Objective To evaluate the therapeutic effect of combined splenorenal shunt and portaazygous devascularization on bleeding esophageal varices.Methods We summarized 120 cases suffering from esophageal variceal bleeding treated by splenorenal shunt plus portaazygods devascularization,from April,1978 to April,1997.Results The operative mortality was 4.2%,no short-term postoperative bleeding,and long-term postoperative bleeding rate was 9.5%,postoperative hepatic encephalopathy rate was 4.8%.Five,ten and fifteen years survival rate were 83.6%,64.5% and 54.5% respectively. The portal hemodynamics was observed by means of Doppler flowmeter,DSA,and intraoperative portal pressure measurement in some of the patients.Conclusion The result showed that combined shunt and portaazygous devacularization not only preserve the advantage of devacularization but also decrease the portal pressure and blood volume,alleviating portal hyperhemodynamics while preserve hepatopetal blood flow to some extent.