Splenorenal Shunt Combined with Pericardial Devascularization in the Treatment of Portal Hypertension

Objective To investigate the effect of the splenorenal shunt(SRS) combined with pericardial devascularization(PCDV) on the patients with portal hypertension.Methods Data of 56 patients with portal hypertension who underwent by splenorenal shunt combined with pericardial devascularization from Feberory 1998 to December 2008 were analyzed retrospectively.Free portal pressure(FPP) during the operation and the information of the diameter,blood flow and thrombosis of portal vein,distributary channel were measured respectively.Summarize the efficacy through the statistics of complication,liver function and rebleeding after the operation.Results The portal pressure was reduced from the preoperative vaule of(37.55±5.37)cm to(25.03± 4.66)cm(P0.05).The statistics of thrombus in splenic vein and distributary channel through CDFI were as follows:0 case in 1 month,1 patient in 3 months,2 patients in 12months,3 patients in 24 month;the diameter of distributary channel was 0.75～1.25cm(0.98±0.37)cm;CDFI showed the blood flow in portal vein toward liver and the blood flow in splenic vein backwards liver.The liver function of all patients recovered to normal level during the follow-up period.There were 4 patients with complication were recorded,all patients with complication were cured after the expectant treatment.Two patients with alimentary tract hemorrhage were found in3,5yeaers after the operation,and the reason of hemorrhage was the forming of thrombus in splenic vein and distributary channel.Conclusion SRS combined with PCDV remains the advantages of the SRS and PCDV and overcomes the shortcomings,so it is a useful operation mode in the treatment of portal hepertension.