Complications after selective pericardial devascularization in portal hypertension patients

Objective:To investigate the incidence and prevention of postoperative complication after selective pericardial devascularization for patients with portal hypertension.Methods: Ninety-six patients with portal hypertension were treated by selective pericardial devascularization.Of the 96 patients,76 were posthepatitic cirrhosis,8 were biliary cirrhosis,3 were schistosomal cirrhosis,and 9 were agnogenic cirrhosis.Selective operation was performed in 64 patients,emergency operation in 14 patients,prophylactic surgery in 18 patients.Results: The total incidence rate of postoperative complication was 23.9%.The incidence of postoperative complication was increased significantly in patients with liver function of Child C grade,serum cholesterin 3.0 mmol/L and total bilirubin 100 mmol/L(P0.05).The operative mortality was 4.2%,and the major death cause was recurrent upper gastrointestinal bleeding combined with hepatic encephalopathy and multiple organ dysfunction syndrome.The 1-,2-,3-year incidence rates of upper gastrointestinal rehaemorrhagia were 3.1%,6.0% and 5.6%,respectively.Conclusion: For portal hypertension patients,selective pericardial devascularization should be performed according to the inclusive criteria,the specification of the surgical procedures and the principle of perioperative management to avoid the postoperative complications.