[Thrombogenesis and its treatment in portal system after devascularization].

OBJECTIVE: To discuss the occurrence of thrombosis in portal system of patients with cirrhotic portal hypertension after devascularization and the methods for treatment and prevention. METHODS: The clinical data of 113 patients with cirrhotic portal hypertension after the devascularization were collected and analyzed retrospectively, and the occurrence time, parts as well as the treatment and prevention methods were discussed. RESULTS: Among the 113 patients, 33 of them were found with thrombosis in their portal system, and the occurrence rate was 29.2%. The occurrence time of thrombosis was 2-15 days post-devascularization, and the median time was 6 days post-operation. Among the 33 cases with thrombosis, there were 19 cases of splenic vein thrombosis, 10 cases of portal thrombosis, and 4 cases of both of them. After the thrombolytic therapy, the thrombosises in 30 cases disappeared. CONCLUSIONS: Most of the thrombosises in portal system happen in splenic vein post-devascularization. Avoiding clamping the trunk of splenic vein in the operation and taking thrombolytic therapy at the early stage after the operation can effectively prevent the occurrence of thrombosis.

[Application of perfusion of low molecular dextran via splenic artery in portal azygous devascularization for portal hypertension].

OBJECTIVE: To evaluate the effects of the perfusion of low molecular dextran via the splenic artery in portal azygous devascularization for portal hypertension in the prevention from portal vein thrombosis. METHODS: A total of 92 patients with portal hypertension were randomly divided into a control group (46 cases) that received the extensive devascularization around the cardia, and a trial group (46 cases) that received the above-mentioned operation and the perfusion of low molecular dextran via the splenic artery. The incidence of portal vein thrombus after the operation and the preoperative and postoperative blood transfusion were observed and the results were analyzed and compared between the two groups. RESULTS: The incidence of thrombosis and blood transfusion were 26.1% (12/46) and CRBC 4~6 U respectively in the control group, while those were 4.3% (2/46) and CRBC 2~3 U respectively in the trial group. The differences were statistically significant (P < 0.05). CONCLUSION: The perfusion of low molecular dextran via the splenic artery in portal azygous devascularization for portal hypertension is effective and safe in the prevention from portal vein thrombosis.