Efficacy of the Combined Operation with the Partial Splenectomy As the Main Technique on Portal Hypertension

Objective To assess the efficacy of combined operation with the partial splenectomy as the main technique in the treatment of portal hypertension.Methods The operation outcome and clinical data of 26 patients (17 male and 9 female, average age of 37 5) with portal hypertension during 1992～2002 were reviewed.This group of patients included 15 cases of advanced schistosomiasis, 10 cases of chronic hepatitis B and 1 unknown case. The number of patients with splenomegaly grade Ⅱand grade Ⅲwere 12 and 14 respectively. All patients were treated with a combined operation by which the partial splenectomy was performed in combination with the coronary vein ligation plus the extensive devascularization around the cardia. Results No operative death occurred in this group. All patients were followed up for 0 3～11 years (4 13 years in average). Eight patients had postoperative hemorrhage from the esophageal varices and seven died. The survival rates of 2, ～4, ～6, ～8, and years post operation were 88 5%, 90 5%, 94 7%, 90 9%, 100%, respectively. Conclusions The combined operation is considered the first choice for the prevention and treatment of portal hypertension. Attention should also be paid to the patients with postoperative hemorrhage from the esophageal varices.