The Clinical Analysis Of Effects Of Three Surgical Treatments For Patients With Portal Hypertension

ObjectiveBy analyzing the different effects of Hassab's procedure, Hassab's procedure combined with esophageal transection and anastomosis with stapler and Hassab's procedure combined with Endoscopic variceal ligation for patients with portal hypertension, and exploring the best reasonable operation in the surgical treatments of portal hypertension.MethodsA retrospective analysis of clininal data of 118 cases of portal hypertension patients admitted for operation from March 2002 to October 2007, 46 underwent Hassab's procedure alone(Hassab's procedure group), 31 underwent Hassab's procedure combined with esophageal transection and anastomosis with stapler(stapler group), 41 treated with Hassab's procedure combined with Endoscopic variceal ligation(combined endoscope group). variations of the albumin, bilirubin, esophagogastric varices , portal hypertensive gastropathy were measured postoperatively (6～12monthes) and the short-term complications and long-term follow-up results were observed and compared .ResultsThe postoperative average values of albumin and bilirubin of the three groups were no difference compared to preoperative value(P>0.05), and also among groups(P>0.05); The postoperative rate of patient with portal hypertensive gastropathy was no significant difference compared to preoperative and also among groups(P>0.05);Rate of complete disappearance of esophageal cvarices of Hassab's procedure group, stapler group and combined endoscope group were respectively (4.5%),(92.9%),(91.9%), three groups were significant difference compared to pre-operation (P<0.01), the completely disappeared rate of stapler group and combined endoscope group was greatly higher than the Hassab's procedure group(P<0.01);there wasn't dead case duration of hospital stay, there were 2 patients died during the one year follow up in Hassab's procedure group ,which occur in stapler group and combined endoscope group were 1 and 0 cases. Rates of rebleeding of stapler group (0.0%)and combined endoscope group(2.7%) were lower than that of Hassab's procedure group(13.6%), there was statistically significant (P<0.05), The rate of complication of stapler group duration of hospital stay(61.3%) was higher than that of Hassab's procedure group(28.3%) and combined endoscope group(31.7%),there was statistically significant(P<0.05)ConclusionsHassab's procedure combined with Endoscopic variceal ligation has more effective in treating esophagogastric varices, it can reduce the rate of rebleeding ,and improve the treatment effect with less complication .It is reasonable treatment of portal hypertension.