Mesocaval shunt plus portaazygous disconnection for portal hypertensive variceal bleeding caused by cavernous transformation of the portal vein in adults / 中华普通外科杂志

ABSTRACT

Objective To investigate the clinical effect of mesocaval shunt and selective coronary vein ligation for portal hypertension caused by cavernous transformation of the portal vein in adults.Methods The clinical data of 26 adult patients with portal hypertensive variceal bleeding caused by cavernous transformation of the portal vein treated by mesocaval shunt plus splenic artery and coronary vein ligation were analyzed retrospectively from 2001 to 2011.Results There was no operative deaths,free portal vein pressure decreased postoperatively,differences were significant before and after shunt (34.4 ± 4.7) cm H2O vs.(24.8 ±2.7) cm H2O,t =12.30,P ＜0.01.Postoperative complications included slight hepatic encephalopathy in 1 case,stress ulcer bleeding in 1 case,which were cured by conservative treatment.23 cases were followed up from 6 months to 4.5 years,and there was no bleeding case.Conclusious Mesocaval shunt plus selective vascular ligation for portal hypertensive variceal bleeding caused by cavernous transformation of the portal vein in adults is safe and effective.