Objective To evaluate the therapeutic effect of selective paraesophagogastric devascularization withoutsplenectomy in treatment of portal hypertension with upper gastrointestinal hemorrhage. Methods The clinical data of 27 patients who received selective paraesophagogastric devascularization without splenectomy from 2008 to 2011 were retrospectively analyzed. The hemogram， hepatic function， perioperative compliations， and free portal pressure （FPP） were observed. The patients were followed-up and the re-bleeding rate and survival rate were observed. Results The FPP decreased significantly（P＜0.05） after operation. The complication rate was 33.3%（9/27） after operation， including2 cases（7.4%） stress ulcer bleeding， 1 case （3.7%） acute bleeding portal hypertensive gastropathy， 1 case （3.7%） deep venous thrombosis， 1 case （3.7%） acute lung injury， 1 case （3.7%） death of hepatic encephalopathy， 3 cases（11.1%） new onset portal vein thrombosis. Twenty-four patients were followed up for an average of 27 months （8-57 months）. The overal survival rate was 92.6% （25/27）. Conclusion Selective paraesophagogastric devascularization without splenectomy is an effective method for treatment of portal hypertension with upper gastrointestinal hemorrhage.
ObjectiveTo evaluate long-term therapeutic effect of esophagogastric devascularization without splenectomy in treatment of portal hypertension with esophagogastric varices hemorrhage. MethodsThe patients who took esophagogastric devascularization without splenectomy from 2008 to 2013 were followed-up in clinic or through phone. The remission of esophagogastric varices, rebleeding, survival and long-term postoperative complications were observed. ResultsA total of 32 patients were taken esophagogastric devascularization without splenectomy in Peking University People's Hospital from 2008 to 2013. One patient died during the perioperative period. Twenty-three patients were followed-up for 10-81 months with an average 45.5 months, of whom 7 patients had rebleeding, 5 patients died, 3 patients had new onset portal vein thrombosis, 2 patients had esophageal anastomotic strictures. ConclusionEsophagogastric devascularization without splenectomy is an effective method in treatment of portal hypertension with esophagogastric varices hemorrhage in selected patients.