[Treating portal hypertension by subtotal splenectomy with retroperitoneal splenic transposition and devascularization: clinical study].
OBJECTIVE
To devise a new surgical procedure for improving the operative effect of portal hypertension caused by hepatic cirrhosis.


METHODS
In treatment group, subtotal splenectomy with retroperitoneal transposition was performed in 36 patients of cirrhotic hypertensives. In control group, 36 patients were treated by devascularization. The follow-up period ranged from 3 months to 5.5 years (average 26 months).


RESULTS
In the treatment group, the rates of disappearance, improvement and absence of changes of esophageal varices were 11.5%, 61.5% and 26.9%, respectively, and in the control group those of improvement were 50.0%, absence of change 45.8% and aggravation 4.2%. There was a significant difference between them (P < 0.05). In the treatment group, hypersplenism disappeared in all. There was also significant difference between the two groups in immunological indexes (P < 0.05). DSA showed abundant collateral circulation in the residual spleen and retroperitoneal wall, which enabled the portal blood flow diverting to retroperitoneal tissues.


CONCLUSIONS
This method possesses the advantages of devascularization and decompression shunt. It is of value in retaining part of spleen in surgical treatment of portal hypertension.
Li
E
E
Department of Surgery, Shandong Linyi Tumor Hospital, Linyi 276001.
Zhao
L
L
Zhu
L
L
Lin
A
A
Ge
L
L
Wang
F
F
Shi
B
B
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D013156:Splenectomy / Q000379:methods*; D013164:Splenorenal Shunt, Surgical / Q000379:methods*