[Effect of combined operation including splenorenal shunt as the main technique for portal hypertension in children].

OBJECTIVE: To assess the effect of combined operation including splenorenal shunt as the main technique for portal hypertension in children. METHODS: 22 patients were reviewed and followed up from 1980 to 1998 (13 male, 9 female). The average age was 9.45 years. Intrahepatic type was shown in 16 patients and prehepatic type in 6. All patients had hematemesis, hematochezia or severe esophageal varices. Liver function was classified Child A in 14 patients, B in 7, and C in 1. Combined operation was performed in all patients. RESULTS: There was no operative death in this group. 21 patients (95.5%) were followed up, with the longest time for 19 years (average 9.58 years). Six patients had hemorrhage from the esophageal varices after operation, and two died of hemorrhage. The survival rates of < 3, -5, -10, -15, > 15 years were 95.2%, 100%, 93.8%, 100%, 100% respectively. No hepatic encephalopathy was noted. CONCLUSION: In treating and preventing hemorrhage from the esophageal varices, combined operation including splenorenal shunt as the main technique is the first choice for the portal hypertension in children. Attention must be paid to the patients who had hemorrhage from the esophageal varices after operation.