Selective double disconnection for cirrhotic portal hypertension.

BACKGROUND

To evaluate the effect of selective double portazygous disconnection with preserving vagus (SDPDPV) for patients with portal hypertension (PHT) in the authors' hospital.

METHODS

Patients (453) with cirrhotic PHT who underwent either SDPDPV or pericardial devascularization with splenectomy (PDS) for variceal bleeding from February 2007 to January 2013 were retrospectively reviewed. The operation-relevant information, change of lavatory examination data, postoperative complications, and clinical outcomes were analyzed.

RESULTS

There were no significant difference between the SDPDPV group and the PDS group of mean operative time and intraoperative blood loss (P >0.05). The free portal pressure in the SDPDPV group was much lower than PDS group significantly after operation (P <0.05). The test of biochemical profile of hepatocyte functions and Child-Pugh score at the end of the first postoperative year were significantly more altered in the SDPDPV group than in the PDS group (P <0.05). Except encephalopathy, occurrences or development of postoperative complications including rebleeding, ascites, and gastric stasis showed great difference between the two groups (P <0.05). The operative mortality rate and the 3-y survival rates were great difference between the two groups too (P <0.05).

CONCLUSIONS

The SDPDPV not only controls recurrent bleeding from varices with PHT effectively but also maintains normal dynamics of stomach and physiological function of intestine and hepatobiliary.