A comparative study on splenorenal shunt and esophagogastric devascularization in the treatment of portal hypertension
10.3760/cma.j.cn113855-20220304-00125
- VernacularTitle:脾肾分流术与断流术治疗门静脉高压症疗效的对比研究
- Author:
Biwen ZHU
1
;
Dongzhi WANG
;
Yan HUANG
;
Qingsong GUO
;
Shajun ZHU
;
Yuhua LU
;
Zhiwei WANG
Author Information
1. 南通大学医学院，南通 226001
- Keywords:
Hypertension,portal;
Splenorenal shunt, surgical;
Treatment outcome;
Devascularization
- From:
Chinese Journal of General Surgery
2022;37(12):903-906
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy of splenorenal shunt and traditional devascularization in the treatment of portal hypertension.Method:The clinical data of 109 patients with portal hypertension due to hepatitis B cirrhosis undergoing splenorenal shunt and traditional devascularization at Affiliated Hospital of Nantong University from Jan 2012 to Nov 2021 were retrospectively analyzed.Results:The operation time (208±43) min in shunt group was longer than that of (172±53) min in devascularization group ( t=-3.677, P<0.05). The intraoperative blood loss of (131±89) ml and postoperative hospital stay (21±6) d in shunt group were not significantly different from those of (164±109) ml and (21±8) d in devascularization group ( t=1.621, P>0.05; t=-0.403, P>0.05). There was no significant difference in the incidence of moderate to severe ascites, intraabdominal hemorrhage and hepatic encephalopathy between the two groups ( χ2=0.973, 0.830, 0.095, all P>0.05). The rebleeding rate in shunt group (5%) was lower than that in devascularization group (28%) ( χ2=5.280, P<0.05). The operation method was an independent predictor of rebleeding. The 1-, 2-, 3-, and 5-year cumulative survival rates in the shunt group were 95%, 94%, 91% and 88%, and in devascularization group were 95%, 88%, 85% and 73%. Rebleeding was an independent risk factor affecting the survival rate, and the risk of death in patients with postoperative rebleeding. Conclusion:Compared with devascularization, splenorenal shunt has obvious advantages in reducing postoperative rebleeding rate and prolonging survival time.
