[Splenectomy combined with endoscopic variceal ligation in treating portal hypertension].
OBJECTIVE
To investigate the therapeutic effect of endoscopic variceal ligation (EVL) combined with splenectomy on patients with portal hypertension.


METHODS
The eliminating rate of varicose veins and recurrent bleeding rate were evaluated. Fifty-one paitents with cirrhosis of liver and portal hypertension were randomly divided into 2 groups. We treated 25 portal hypertensive patients using splenectomoy plus EVL. The therapeutic effect of pericardial devascularization in 26 patients with upper gastrointestinal bleeding due to portal hypertension served as the control.


RESULTS
All patients were followed up for 12 months. There was no death due to the operation. All patients in the study group had no upper gastrointestinal rebleeding during the 12-month follow-up. The rebleeding rate in the control group was 11.5% (3/26). The varicose venis eliminating rate was 96% (24/25) in the study group and 50% (13/26) in the control group (P < 0.01). It showed no effect on portal hypertensive gastropathy in the study group, and pericardial devascularization procedure exacerbated the portal hypertensive gastropathy. The thrombosis rate in the portal vein after the operation was 8% (2/25) in the study group and 34.6% (9/26) in the control group (P < 0.05).


CONCLUSIONS
EVL combined with splenectomy has less trauma, fewer postoperative complications and high eradication of esophageal varices. It can be used safely in treating portal hypertension.
Liu
Bo
B
Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha 410011, China.
Lin
Nan
N
Xu
Rui-Yun
RY
D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery*; D008026:Ligation; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D008297:Male; D055502:Secondary Prevention; D013156:Splenectomy