Application of pericardial devascularization and omental packing combined with gastric noose cerclage in treatment of portal hypertension / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the application of pericardial devascularization and omental packing combined with gastric noose cerclage in the treatment of portal hypertension. MethodsThe clinical data of 59 patients who were treated in our hospital and received pericardial devascularization and omental packing combined with gastric noose cerclage from June 2007 to June 2013 were analyzed retrospectively, and the indices such as changes in portal venous pressure, portal vein diameter, and liver function after surgery, postoperative rebleeding rate, and survival rate were observed. Analysis of variance was applied for comparison between multiple groups, and paired t-test was applied for comparison between two groups. ResultsAll the 59 patients received a successful surgery, and the portal venous pressure was significantly decreased after the surgery; after the emergency operation, upper gastrointestinal bleeding was stopped, with no complications such as gastroparesis and pancreatic fistula; there was no death. The postoperative follow-up was performed for 2~5 years, and 1 case of rebleeding and 1 death occurred. ConclusionPericardial devascularization and omental packing combined with gastric noose cerclage have the advantages of both devascularization and shunt, and can achieve complete devascularization of the vessels at the lower segment of the esophagus, the cardia, and the gastric fundus, and the submucosal vessels in the gastric wall, with exact hemostasis, few postoperative complications, low rebleeding rate, and simplicity in operation, which is a reasonable, reliable, safe, and effective operation method.