Evaluation Of Effect And Surgical Indications Using Prophylactic Devascularization For Portal Hypertension

Objective: To explore and analyze the effect and surgical indication of prophylactic pericardial divascularization with splenectomy; Method: 101 cases of intrahepatic portal hypertension, which were treated by divascularization with spleenectomy are randomized to treating operation (Group Ⅰ :n=56) or prophylactic operation (Group Ⅱ :n=45); Both groups have been follow up after operation; Group I (22.6 ± 16.8 month);Group Ⅱ(22.9 ± 15.3 month); Group Ⅰ and Ⅱ patients had comparable baseline characteristics, actuarial probability of rebleeding and survival; Cox regression analysis was performed to assess the variables predicting the incidence of rebleeding; actuarial probability of rebleeding was analyzed according to the Child's status; Results: The actuarial probability of rebleeding at 2 year and 5 year were significantly lower in Group Ⅱ compared to Group Ⅰ (10.3% vs 37.2%, 51.2% vs 58.7%; p=0.02 ); there was no difference in the probability of survival in both groups; It turned out that Child's status was the only factor that predicted rebleeding; The acturial probability of rebleeding at 2 year was significantly higher in Child's C compared to Child's A and B patients (p=0.001); Conclusion: Prophylactic divascularization was considered to be a reasonable operative method in treating of portal hypertension; its surgical indication...