Surgical Treatment of Cavernous Transformation of the Portal Vein in Adult

Objective To investigate the best surgical treatment methods for cavernous transformation of the portal vein (CTPV) in adult.Methods A retrospective study was made on clinical data of 35 adult patients with CTPV. Results Splenic artery and coronary vein ligation plus C type mesocaval shunt with artificial graft was performed in 14 cases. 10 cases rebleeding after splenectomy and devascularization, 8 cases were performed C type mesocaval shunt, 1 case was performed inferior meso-caval shunt and 1 patient received jejunectomy due to variceal hemorrhage within the jejunum. 6 cases were performed splenocaval shunt. 2 cases were performed splenopneumopexy. 1 case was performed splenorenal shunt. 1 case was performed portocaval shunt. 1 case was performed splenectomy plus pericardial devascularization. All patients' gastroesophageal varices were reduced or disappearance. No bleeding and hepatoencephalopathy occurred in follow-up 6 months to 4.5 years. Conclusion Portasystemic shunt plus porta-azygous devascularization is the best choice for treatment of CTPV.