Proximal spleno-renal shunt plus pericardial devascularization for management of portal hypertension

Objective: To observe the clinical efficacy of proximal spleno-renal shunt(PSS) plus pericardial devascularization(PD) in treatment of patients with portal hypertension. Methods: One hundred and twelve patients with portal hypertension were managed by PSS plus PD(31 cases) and PD only(81 cases). The changes in the free portal pressure before and after surgery as well as the short and long term efficacy were observed. Results: The free portal pressure decreased more obviously in the combination therapy group than in the PD group(P < 0.01); there were no significant differences in the mortality rate,recent re-bleeding rate and incidence of hepatic encephalopathy between the two groups(P > 0.05); the incidence of long-term re-bleeding and ascites in the combination therapy group was lower than that in the PD group (P < 0.05); the incidence of long-term hepatic encephalopathy had no significant difference between the two groups(P > 0.05). Conclusions: PSS plus PD is the choice therapy for portal hypertension combined with hemorrhage, which integrates the advantages of PSS and PD,decreasing the incidence frebreeding and avoiding the increase of hepatic encephalopathy.