Orthotopic spelenectomy and selective pericardial devascularization for portal hypertension
10.3760/cma.j.issn.1007-631X.2016.10.001
- VernacularTitle:原位脾切除联合选择性贲门周围血管离断术治疗门静脉高压症
- Author:
Xiaojun ZHANG
;
Min ZHOU
;
Jun ZHANG
;
Xinchun JIANG
;
Xinhui ZHANG
- Publication Type:Journal Article
- Keywords:
Hypertension,portal;
Splenectomy;
Selective pericardial devascularization
- From:
Chinese Journal of General Surgery
2016;31(10):801-803
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate orthotopic splenectomy and pericardial devascularization for the treatment of portal hypertension.Methods The modified anterior approach splenectomy includes dissection of the peri-splenic vessels and ligments before division of short gastric vessels.During pericardial devascularization,the dessection panel was close to the esophagus and the stomach,leaving intact both the anterior and posterior vagus trunks.Results 63 patients underwent this modified operation.The free portal pressure decreased from (38 ±4) cmH2O to(28 ±4)cmH2O.The average blood loss was (530 ± 37)ml.There was no mortality,nor perioperative gastric paralysis and portal venous thrombosis.By 12-36 months follow-up,there was no pancreatic leakage,hepatic coma and recurrence of bleeding.Intrahepatic portal venous thromboses were detected in 4 cases at the sixth postoperative months.Conclusions This modified splenectomy plus selective pericardial devascularization carries less bleeding and is safe and effective for the treatment of portal hypertension.
