Improved Splenectomy In Pericardial Devascularization For The Treatment Of Portal Hypertension

Pericardial devascularization with splenectomy is commonlyused for the treatment of variceal bleeding of portal hypertension;thisoperation has been proved effective in controlling bleeding.Splenectomy is the first step of this operation. The discussions ofwhether to do partial splenectomy in this operation exist for manyyears. In our hospital, we began to do this operation for more than10 years and we do total splenectomy in the operation. In the clinicalwork, we began to use new method of splenectomy during theoperation. We deal with the spleen in this way: deal with stem of the spleenfirst, then with the spleen ligament, do not move the spleen during theoperation, just keep the spleen in its original position. We just call thiskind of splenectomy "Improved Splenectomy". We evaluate the efficacy of two kind of way of splenectomy forthe treatment of portal hypertension. The Methods is: The improvedsplenectomy plus devascularization and classical splenectomy plusdevascularization were used to treat the portal hypertension, 33improved and 36 traditional splenectomy cases during the period of2001.7 to 2005.7 were compared as to haemorrhage, number ofpatients received transfusion, operation time, days in hospital afteroperation, the incidence of pancreatic fistula and splenic infection.The Results: In improved group, the haemorrhage, number of patientsreceived transfusion were better compared with traditional operationgroup and with lower incidence of resent complications. Conclusion:Compared with the classical splenectomy plus devascularization, theimproved splenectomy is a good operative procedure, with lessbleeding and lower incidence of resent complications (pancreaticfistula).