The therapeutic effect of selective pericardial devascularization on portal hypertention

Objective To evaluate the curative effect of selective pericardial devascularization on portal hypertention.Methods From January, 2002 to March, 2004, 47 cases of portal hypertension were treated by selective pericardral devascularization and 104 cases by standardized pericardial devascularization. Free portal vein pressure was measured before operation, after splenectomy and after operation. Portal vein blood flow at admission and on 14th day after operation was determined by ultrasonography. The incidence of rebleeding, hepatic encephalopathy, portal hypertensive gastropathy, ameliorative degree of ascites and gastroesophageal variceal and survival time were observed.Results Compared with the controls, the patients undergoing selective pericardial devascularization showed decreased incidence of rebleeding (P 0.05 ) and portal hypertensive gastropathy (P 0.05 ), evidently reduced free portal vein pressure (P 0.01 ), significant improvement of ascites and gastroesophageal variceal (P 0.05 ), and obviously reduced portal vein blood flows (P 0.01 ), but the risk of hepatic encephalopathy was not increased (P 0.05 ).Conclusion Selective pericardial devascularization reserved spontaneous shunts and had virtues of shunt and disconnection, It was a reasonable surgical method.