Combined splenocaval or mesocaval C shunt and portoazygous devascularization in the treatment of portal hypertension: analysis of 150 cases.
BACKGROUND
Portal hypertension is a common disease and its major surgical therapeutic approaches include devascularization and shunting. This study was undertaken to investigate the effects of combined splenocaval or mesocaval C shunt and portoazygous devascularization (combined procedures) on portal hypertension.


METHODS
The clinical data of 150 patients with portal hypertension who had undergone combined procedures at the First Affiliated Hospital of Zhengzhou University from May 1990 to May 2003 were analyzed retrospectively.


RESULTS
The mean free portal pressure (FPP) was 25.6+/-1.83 mmHg, 18.0+/-2.07 mmHg and 18.4+/-2.19 mmHg before operation, after splenectomy plus splenocaval or mesocaval C shunt, and combined procedures, respectively. There was no operative death in all patients. The 1-7 year follow-up of 100 patients showed rebleeding in 3 patients, encephalopathy in 4, thrombosis of artificial vascular graft in 3, and dying from liver failure in 2.


CONCLUSIONS
The combined procedures can not only decrease portal pressure but also preserve hepatic blood flow to some extent. It may be one of the best choices for treating portal hypertension in China.
Feng
Liu-Shun
LS
Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. Fengliushun@yahoo.com
Chen
Xiao-Ping
XP
D000293:Adolescent; D000328:Adult; D001401:Azygos Vein / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure / Q000502:physiology; D011169:Portal Vein / Q000601:surgery*; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D013162:Splenic Vein / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery*