Comparative therapeutic effects of selective and non-selective devascularization procedures in the surgical treatment of portal hypertension

Objectives To evaluate comparatively the therapeutic effects of selective and non-selective devascularization procedures in the surgical treatment of portal hypertension.Methods A total of 176 cases of hepatic cirrhosis with portal hypertension guided by united selection and exclusion criterias were randomly divided into 2 groups:91 patients were submitted to selective devascularization procedure(observation group), and 85 patients were non-selectively submitted to the pericardial devascularization procedure(control group).Results No significant difference of free portal pressure(FPP) was shown between the 2 groups before and after splenectory(P0.05).The FPP was(29.8±5.1)cm H2O in the control group, and(26.4±5.2)cm H2O in the observation group at the end of the operation(P0.05).The Child-Pugh scores, presence of ascites, the hepatic artery blood flow, the degree of gastroesophageal varices, the incidence of portal hypertention gastropathy and ulcer were relatively better in the observation group than those in the control group(P0.05) 6 months after operation.Conclusions The selective devascularization procedure reasonably preserves the patient's spontaneous capacity of blood diversion, thus helps achieving a dynamic balance between guaranteeing blood flow into the portal vein and reduction in the portal vein pressure.This appears to be an ideal procedure in the treatment of portal hypertension.