Clinical analyzed of esophageal by varical-preserving with selective devascularization on portal hypertension

Objectives To investigate the clinical effects of selective devascularization procedures in the surgical treatment of portal hypertension.Methods The clinical data of 90 patients with the selective devascularization therapy on portal hypertension secondary to liver cirrhosis were analyzed retrospectively from January 2004 to March 2010.Results The incidence rate of postoperative complication was 22.2% and FPP average decrease was 6±7 cmH2O.The incidence of postoperative complication was increased significantly in patients with liver function of child C grade,Serum cholesterin3.0 mmol/L(P0.05);The operative mortality was 3.1% and the major cause of death was recurrent upper gastrointestinal bleeding combined with hepatic encephalopathy and multiple organ dysfunction syndrome.The 1-,3-,5-year incidence rates of upper gastrointestinal rehaem orrhagia were 3.3%、5.6 and 4.8% respectively.Conclusions The selective devascularization procedure reasonably preserves the patient's capacity of spontaneous blood diversion,thus helps achieving a dynamic balance which guarantees both blood flow into the portal vein and reduction of the portal vein pressure.This appears to be an optimal procedure in the treatment of portal hypertension.More attention should be paid to patients with poor liver function and repeated bleeding.