Portal azygous devascularization for the treatment of patients with portal hypertension

Objective To evaluate therapeutic effects of portal azygous devascularization on patients with portal hypertension. Methods In this study, data of 212 patients with portal hypertension who underwent devascularization were analyzed retrospectively. Among them 52% patients had a history of variceal bleeding. Preoperative Child A accounted for 15% patients, B for 57% and C for 27%. Emergent operation and selective operation were performed in 11% and 89% cases, respectively. Hassab procedure was performed in 176 cases (83%), whereas modified Sugiura procedure in 36 cases (17%). Results Portal vein pressure decreased from (40±6) cm?H 2O to (36±7) cm?H 2O. The re-bleeding rate of 3, 5,10 years were 2%, 6%, 11%, and the survival rates of 3, 5, 10 years were 97%, 92% and 89%, respectively. Conclusions Devascularization is an effective procedure in controlling bleeding with low incidence of liver failure, operation mortality and encephalopathy. Emergent operation should be avoided as it causes high morbidity and mortality. The decreased portal pressure following devascularization may result in a reduced blood supply to the liver. Persistent exasperation of the liver function caused by chronic hepatitis and the development of hepatocellular carcinoma are the two major factors endangering long-term survival.