Study Of The Spleen Preserving Selective Devascularization Operation Combined Splenorenal Shunt Bridge And Open Surgery On The Immune Function

Objective:To investigate the efficacy to immune function for the patients who hadthe treatment of cirrhosis and portal hypertension with the spleen preserving selectivedevascularization operation combined splenorenal shunt bridge and Safety andclinical effects.Methods:These51patients with cirrhosis and portal hypertension had surgicaltherapy,21of them were operated by the spleen preserving selective devascularizationoperation combined spleenorenal shunt bridge (the combined group),and the other30patients had the surgery with the traditional pericardial vascular amputation (thedevascularization group). Collect relevant information, such as liver function,operative time, complications, and follow-up6months after surgery with or withoutupper gastrointestinal bleeding occurred,Observe WBC,platelet before operation and1week,4weeks after operation, immunoglobulin (IgG, IgM, IgA) and T lymphocytesubsets (CD4~+、CD8~+、CD4~+/CD8~+) before operation and after4weeks of operation.Collect relevant data, comparative analysis of two groups preoperative, perioperative,postoperative complications and the impact on the immune function of the situationResults: Smooth operation of two groups of patients. the combined group comparedto the devascularization group, It ’s longer in operative time (p <0.05), intraoperativeblood loss, postoperative passage of flatus, Get out of bed time,it was no significantdifference between the two. Postoperative complications such as pancreatic fistula,pulmonary infection, wound infection incidence was no significant difference. thedevascularization group within six months after surgery, had three cases ofrecurrence of upper gastrointestinal bleeding, the combined group, no case. Afteroperations,WBC and platelets increased.Compare to the combined group,platelet ofthe devascularization group increased significantly1week after operation (P﹤0.001).Two groups got to normal range after4weeks.After operation, Tuftsin0f thedevascularization group were significantly lower,it was little change in the combinedgroup，difference between two groups was statistically significant(P<0.001).IgMdecreased in the devascularization group,it was increased in the combined group,the difference between the two groups was statistically significant (P﹤0.001). CD4~+、CD8~+、CD4~+/CD8~+of the devascularization group decreased after operation,whilelittle change in the combined group,the two groups was statistically significant (P<0.05).Conclusion:The surgery of spleen preserving selective devascularization operationcombined splenorenal shunt bridge for the treatment of portal hypertension wasFeasible and safe clinical effect and can relieve the hypersplenism,improving thepatient’s immune function.