title: Esophagogastric devascularization without splenectomy in portal hypertension: safe and effective?
abstract: BACKGROUND
  Esophagogastric variceal hemorrhage is a life-threatening complication of portal hypertension. In this study, we compared the therapeutic effect of a novel surgical procedure, esophagogastric devascularization without splenectomy (EDWS), with the widely used modified esophagogastric devascularization (MED) with splenectomy for the treatment of portal hypertension.
  
  
  METHODS
  Fifty-five patients with portal hypertension were included in this retrospective study. Among them, 27 patients underwent EDWS, and the other 28 patients underwent MED. Patients' characteristics, perioperative parameters and long-term follow-up were analyzed.
  
  
  RESULTS
  The portal venous pressure was decreased by 20% postoperatively in both groups. The morbidity rate of portal venous system thrombosis in the EDWS group was significantly lower than that in the MED group (P=0.032). The 1- and 3-year recurrence rates of esophagogastric variceal hemorrhage were 0% and 4.5% in the EDWS group, and 0% and 8.7% in the MED group, respectively (P=0.631).
  
  
  CONCLUSIONS
  EDWS is a safe and effective treatment for esophagogastric varices secondary to portal hypertension in selected patients. Patients treated with EDWS had a lower complication rate of portal venous system thrombosis compared with those treated with conventional MED.
authors.affiliation: Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044, China. gandanwk@vip.sina.com.
authors.forename: Yan-Bin
authors.initials: YB
authors.lastname: Ni
authors.forename: Peng-Ji
authors.initials: PJ
authors.lastname: Gao
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
authors.forename: Zhao
authors.initials: Z
authors.lastname: Li
authors.forename: Ji-Ye
authors.initials: JY
authors.lastname: Zhu
mesh_terms: D000328:Adult; D018572:Disease-Free Survival; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006489:Hemostatic Techniques / Q000009:adverse effects; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D014690:Venous Pressure; D020246:Venous Thrombosis / Q000209:etiology