Modified pericardial devascularization combined with splenorenal shunt for portal hypertension with upper digestive tract hemorrhage

Objective To evaluate the effect of modified pericardial devascularization(MPCDV) combined with splenorenal shunt(SRS) for portal hypertension with upper digestive tract hemorrhage.Methods We reviewed retrospectively 22 patients with portal hypertension associated with upper digestive tract hemorrhage who had been treated by MPCDV+SRS and 20 patients who had been treated by MPCDV from January 1998 to December 2007.Their hepatic function before the operation,free portal pressure(FPP) during the operation,and color Doppler flow imaging 14-21 days after the operation were measured respectively.Results There was no operative mortality,re-bleeding and hepatic encephalopathy during the operation.The 1-and 3-year postoperative survival rates were 100% and 95.5% respectively.Conclusions MPCDV combined with SRS not only remains pyloric function and MPCDV,but also reduces the portal pressure,resulting in portal hypertensive gastropathy(PHG)or hemorrhage.It is capable of ensuring hepatopetal blood flow of the portal vein while facilitating the recovery of liver function and disappearance of ascites.