title: Clinical analysis of surgical treatment of portal hypertension.
abstract: OBJECTIVE
  To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different conditions.
  
  
  METHODS
  The data of 508 patients with portal hypertension treated surgically in 1991-2001 in our centers were analyzed. Of the 508 patients, 256 were treated with portaazygous devascularization (PAD), 167 with portasystemic shunt (PSS), 62 with selective shunt (SS), 11 with combined portasystemic shunt and portaazygous devascularization (PSS+PAD), 9 with liver transplantation (LT), 3 with union operation for hepatic carcinoma and portal hypertension (HCC+PH).
  
  
  RESULTS
  In the 167 patients treated with PSS, free portal pressure (FPP) was significantly higher in the patients with a longer diameter of the anastomotic stoma than in those with a shorter diameter before the operation (P < 0.01). After the operation, FPP in the former patients markedly decreased compared to the latter ones (P < 0.01). The incidence rate of hemorrhage in patients treated with PAD, PSS, SS, PSS+PAD, and HCC+PH was 21.09% (54/256), 13.77 (23/167), 11.29 (7/62), 36.36% (4/11), and 100% (3/3), respectively. The incidence rate of hepatic encephalopathy was 3.91% (10/256), 9.58% (16/167), 4.84% (3/62), 9.09% (1/11), and 100% (3/3), respectively while the operative mortality was 5.49% (15/256), 4.22% (7/167), 4.84% (3/62), 9.09% (1/11), and 66.67% (2/3) respectively. The operative mortality of liver transplantation was 22.22% (2/9).
  
  
  CONCLUSIONS
  Five kinds of operation in surgical treatment of portal hypertension have their advantages and disadvantages. Therefore, the selection of operation should be based on the actual needs of the patients.
authors.affiliation: Department of Hepatobiliary Surgery, People's Hospital, Peking University, Beijing 100044, China. x_xb@163.net
authors.forename: Xin-Bao
authors.initials: XB
authors.lastname: Xu
authors.forename: Jing-Xiu
authors.initials: JX
authors.lastname: Cai
authors.forename: Xi-Sheng
authors.initials: XS
authors.lastname: Leng
authors.forename: Jia-Hong
authors.initials: JH
authors.lastname: Dong
authors.forename: Ji-Ye
authors.initials: JY
authors.lastname: Zhu
authors.forename: Zhen-Ping
authors.initials: ZP
authors.lastname: He
authors.forename: Fu-Shun
authors.initials: FS
authors.lastname: Wang
authors.forename: Ji-Run
authors.initials: JR
authors.lastname: Peng
authors.forename: Ben-Li
authors.initials: BL
authors.lastname: Han
authors.forename: Ru-Yu
authors.initials: RY
authors.lastname: Du
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006470:Hemorrhage / Q000401:mortality / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000401:mortality* / Q000601:surgery*; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical / Q000401:mortality*; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies