Treatment of portal hypertension with limited portacaval shunt in combination with portoazygous devascularization

Objective To investigate the value of limited portacaval shunt in combination with portoazygous devascularization in treatment of portal hypertension. Methods From May 1983 to May 1998, the combined operation (limited side-to-side portacaval shunt with ligation of splenic artery and gastric coronary vein) was performed on 94 patients in our hospital. All these patients suffered from variceal hemorrhage secondary to portal hypertension caused by portal cirrhosis. According to Child′s classification, 45 were of class A and 49 of class B. We retrospectively analyzed the follow-up results of these patients. Results All the patients survived the operation. The follow-up study in 84 patients showed that the occurring rate of hemorrhage of upper digestive tract was 8.3% and that of shunt-related encephalopathy 7.1%. Conclusions The combined operation is valuable for treatment of variceal bleeding secondary to portal hypertension, especially prevention of post-operative shunt-related encephalopathy, and for control of congestive splenomegaly.