Zhonghua wai ke za zhi [Chinese journal of surgery] · 1998
[Treating portal hypertension by subtotal splenectomy with retroperitoneal splenic transposition and devascularization: clinical study].
Клиническое исследованиеАннотация на английскомСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Li E, Zhao L, Zhu L, Lin A, Ge L, Wang F, Shi B
Аннотация
OBJECTIVE: To devise a new surgical procedure for improving the operative effect of portal hypertension caused by hepatic cirrhosis.
METHOD: In treatment group, subtotal splenectomy with retroperitoneal transposition was performed in 36 patients of cirrhotic hypertensives. In control group, 36 patients were treated by devascularization. The follow-up period ranged from 3 months to 5.5 years (average 26 months).
RESULT: In the treatment group, the rates of disappearance, improvement and absence of changes of esophageal varices were 11.5%, 61.5% and 26.9%, respectively, and in the control group those of improvement were 50.0%, absence of change 45.8% and aggravation 4.2%. There was a significant difference between them (P < 0.05). In the treatment group, hypersplenism disappeared in all. There was also significant difference between the two groups in immunological indexes (P < 0.05). DSA showed abundant collateral circulation in the residual spleen and retroperitoneal wall, which enabled the portal blood flow diverting to retroperitoneal tissues.
CONCLUSION: This method possesses the advantages of devascularization and decompression shunt. It is of value in retaining part of spleen in surgical treatment of portal hypertension.
METHOD: In treatment group, subtotal splenectomy with retroperitoneal transposition was performed in 36 patients of cirrhotic hypertensives. In control group, 36 patients were treated by devascularization. The follow-up period ranged from 3 months to 5.5 years (average 26 months).
RESULT: In the treatment group, the rates of disappearance, improvement and absence of changes of esophageal varices were 11.5%, 61.5% and 26.9%, respectively, and in the control group those of improvement were 50.0%, absence of change 45.8% and aggravation 4.2%. There was a significant difference between them (P < 0.05). In the treatment group, hypersplenism disappeared in all. There was also significant difference between the two groups in immunological indexes (P < 0.05). DSA showed abundant collateral circulation in the residual spleen and retroperitoneal wall, which enabled the portal blood flow diverting to retroperitoneal tissues.
CONCLUSION: This method possesses the advantages of devascularization and decompression shunt. It is of value in retaining part of spleen in surgical treatment of portal hypertension.