title: Two surgical procedures for esophagogastric variceal bleeding in patients with portal hypertension.
abstract: OBJECTIVE
  To determine the clinical value of a splenorenal shunt plus pericardial devascularization (PCVD) in portal hypertension (PHT) patients with variceal bleeding.
  
  
  METHODS
  From January 2008 to November 2012, 290 patients with cirrhotic portal hypertension were treated surgically in our department for the prevention of gastroesophageal variceal bleeding: 207 patients received a routine PCVD procedure (PCVD group), and 83 patients received a PCVD plus a splenorenal shunt procedure (combined group). Changes in hemodynamic parameters, rebleeding, encephalopathy, portal vein thrombosis, and mortality were analyzed.
  
  
  RESULTS
  The free portal pressure decreased to 21.43 ± 4.35 mmHg in the combined group compared with 24.61 ± 5.42 mmHg in the PCVD group (P < 0.05). The changes in hemodynamic parameters were more significant in the combined group (P < 0.05). The long-term rebleeding rate was 7.22% in the combined group, which was lower than that in the PCVD group (14.93%), (P < 0.05).
  
  
  CONCLUSIONS
  Devascularization plus splenorenal shunt is an effective and safe strategy to control esophagogastric variceal bleeding in PHT. It should be recommended as a first-line treatment for preventing bleeding in PHT patients when surgical interventions are considered.
authors.affiliation: Lin Yang, Li-Juan Yuan, Rui Dong, Ji-Kai Yin, Qing Wang, Tao Li, Jiang-Bin Li, Xi-Lin Du, Jian-Guo Lu, Department of General Surgery, Tangdu Hospital of the Fourth Military Medical University, Xi'an 710038, Shannxi Province, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.affiliation: Lin Yang, Li-Juan Yuan, Rui Dong, Ji-Kai Yin, Qing Wang, Tao Li, Jiang-Bin Li, Xi-Lin Du, Jian-Guo Lu, Department of General Surgery, Tangdu Hospital of the Fourth Military Medical University, Xi'an 710038, Shannxi Province, China.
authors.forename: Li-Juan
authors.initials: LJ
authors.lastname: Yuan
authors.affiliation: Lin Yang, Li-Juan Yuan, Rui Dong, Ji-Kai Yin, Qing Wang, Tao Li, Jiang-Bin Li, Xi-Lin Du, Jian-Guo Lu, Department of General Surgery, Tangdu Hospital of the Fourth Military Medical University, Xi'an 710038, Shannxi Province, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Dong
authors.affiliation: Lin Yang, Li-Juan Yuan, Rui Dong, Ji-Kai Yin, Qing Wang, Tao Li, Jiang-Bin Li, Xi-Lin Du, Jian-Guo Lu, Department of General Surgery, Tangdu Hospital of the Fourth Military Medical University, Xi'an 710038, Shannxi Province, China.
authors.forename: Ji-Kai
authors.initials: JK
authors.lastname: Yin
authors.affiliation: Lin Yang, Li-Juan Yuan, Rui Dong, Ji-Kai Yin, Qing Wang, Tao Li, Jiang-Bin Li, Xi-Lin Du, Jian-Guo Lu, Department of General Surgery, Tangdu Hospital of the Fourth Military Medical University, Xi'an 710038, Shannxi Province, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Lin Yang, Li-Juan Yuan, Rui Dong, Ji-Kai Yin, Qing Wang, Tao Li, Jiang-Bin Li, Xi-Lin Du, Jian-Guo Lu, Department of General Surgery, Tangdu Hospital of the Fourth Military Medical University, Xi'an 710038, Shannxi Province, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Li
authors.affiliation: Lin Yang, Li-Juan Yuan, Rui Dong, Ji-Kai Yin, Qing Wang, Tao Li, Jiang-Bin Li, Xi-Lin Du, Jian-Guo Lu, Department of General Surgery, Tangdu Hospital of the Fourth Military Medical University, Xi'an 710038, Shannxi Province, China.
authors.forename: Jiang-Bin
authors.initials: JB
authors.lastname: Li
authors.affiliation: Lin Yang, Li-Juan Yuan, Rui Dong, Ji-Kai Yin, Qing Wang, Tao Li, Jiang-Bin Li, Xi-Lin Du, Jian-Guo Lu, Department of General Surgery, Tangdu Hospital of the Fourth Military Medical University, Xi'an 710038, Shannxi Province, China.
authors.forename: Xi-Lin
authors.initials: XL
authors.lastname: Du
authors.affiliation: Lin Yang, Li-Juan Yuan, Rui Dong, Ji-Kai Yin, Qing Wang, Tao Li, Jiang-Bin Li, Xi-Lin Du, Jian-Guo Lu, Department of General Surgery, Tangdu Hospital of the Fourth Military Medical University, Xi'an 710038, Shannxi Province, China.
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017082:Portal Pressure; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Comparative study; Devascularization; Esophagogastric variceal bleeding; Portal hypertension; Splenorenal shunt