Abstract:
AIM:To investigate the therapeutic efficacy and complications of splenectomy with endoscopic variceal ligation (EVL) and splenectomy with pericardial devascularization (i.e. Hassab's operation) in patients with portal hypertension. METHODS:A total of 103 patients with liver cirrhosis and portal hypertension were randomly selected to receive either splenectomy with EVL (n = 53, group A) or Hassab's operation (n = 50, group B). RESULTS:The portal blood flow volume, the presence of portal vein thrombosis, gastric emptying time and free portal venous pressure (FPP) before and after the operation were determined. Patients were followed up for up to 64 mo with an average of 45 mo, and the Dagradi classification of variceal veins and the grading of portal hypertension gastropathy (PHG) were evaluated. It was found that all esophageal varices were occluded or decreased to grade II or less in both groups. There was little difference in the recurrence rate of esophageal varices (11.9% vs 13.2%) and the re-bleeding rate (7.1% vs 5.3%) between groups A and B. The incidence of complications and the percentage of patients with severe PHG after the operation were significantly higher in group B (60.0% and 52.0%) than in group A (32.1% and 20.8%, P < 0.05). No patients died of operation-related complications. There was no significant difference in gastric emptying time, FPP and portal blood flow volume between the two groups. CONCLUSION:The results suggest that splenectomy with EVL achieves similar therapeutic efficacy to that of Hassab's operation in terms of the recurrence rate of esophageal varices and the re-bleeding rate, but the former results in fewer and milder complications.
journal_name
World J Gastroenteroljournal_title
World journal of gastroenterologyauthors
Lin N,Liu B,Xu RY,Fang HP,Deng MHdoi
10.3748/wjg.v12.i45.7375subject
Has Abstractpub_date
2006-12-07 00:00:00pages
7375-9issue
45eissn
1007-9327issn
2219-2840journal_volume
12pub_type
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v18.i31.4169
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pub_type: 杂志文章
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journal_title:World journal of gastroenterology
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doi:10.3748/wjg.v16.i31.3897
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,meta分析
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,meta分析,评审
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更新日期:2013-10-28 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.3748/wjg.v12.i19.3015
更新日期:2006-05-21 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 社论
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更新日期:2016-08-07 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2010-12-14 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v23.i25.4517
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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journal_title:World journal of gastroenterology
pub_type: 临床试验,杂志文章
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