Hemodynamic changes in combined operation of portal azygous devascularization with mesocaval shunt for portal hypertension

Objective To investigate the hemodynamic changes and clinical significance of combination of portal azygous devascularization with mesocaval shunt (combined operation). Methods Retrospective study was made on 100 patients who underwent the combined operation in 1980～1995 in our hospital. Results Acute bleeding in all patients was stopped in a short period postoperatively and no rebleeding occurred in early or late stages. Incidence of encephalopathy during the follow up period was 5.6%; total mortality 26%; decline in FPP postoperatively 19.58?cm H 2O, which was favorable to stop the bleeding. A postoperative mean FPP level was 25.09±3.1?cmH 2O, which can maintain a high level of hepatopetal portal flow and reduce the occurrence of encephalopathy. Conclusions The combined operation obtaining characteristics from both devascularization and shunt procedure is a perfect union of two separated surgical treatments, as well as a good choice for portal hypertension.