Comparison between devascularization and shunt in portal hypertension treatment

Objective To investigate the curative effect of the shunt operation versus splenectomy and pericardial devascularization in the treatment of patients with portal hypertension.Methods Retrospective analysis was made of the clinical data of 113 patients who suffered from portal hypertension and accepted the treatment of the shunt operation or splenectomy and pericardial devascularization from June 2005 to June 2012.We compared the symptoms of hypersplenism,liver function,esophageal varices in patients before and after surgery,compared the operative mortality and the incidence of postoperative bleeding,hepatic encephalopathy and portal vein thrombosis.Results According to the clinical data,the FPP after treatment was lower than before.The difference was statistically significant(P 0.05),and the FPP after treatment in two groups of patients had no statistically significant difference(P 0.05).During the follow-up period,the occurrence of esophageal and gastric varices as well as the disappearance rate of ascites in the shunt operation group were lower than those of the pericardial devascularization group(P 0.05).But the liver function between the two groups was not statistically significant(P 0.05).Moreover,the rate of hepatic encephalopathy in the shunt operation group was pretty much higher than that of the pericardial devascularization group(P 0.01).However,the incidence of postoperative hemorrhage and portal vein thrombosis between two groups were completely opposite(P 0.05).Conclusions For patients with portal hypertension,the splenectomy and pericardial devascularization has a better therapeutic effect compared with the shunt operation,which has less prone to hepatic encephalopathy,better maintenance in hepatic blood flow and does a good job in hemostasis which leads to a better liver function.Moreover,it causes less surgical trauma,lower operative mortality.Also,it’s easy to operate and to promote in the whole country.