Comparison of simplified and traditional pericardial devascularisation combined with splenectomy for the treatment of portal hypertension  

作　　者：Ya-Fei Zhang Hong Ji Hong-Wei Lu Le Lu Lei Wang Jin-Long Wang Yi-Ming Li 

机构地区：[1]Department of General Surgery,the Second Affiliated Hospital of Xi’an Jiaotong University

出　　处：《World Journal of Clinical Cases》2018年第6期99-109,共11页世界临床病例杂志

基　　金：Supported by National Natural Science Foundation of China,No.81170454

摘　　要：AIM To compare the clinical outcomes of patients with portal hypertension(PH) who underwent treatment with splenectomy plus simplified pericardial devascularisation(SSPD) or splenectomy plus traditional pericardial devascularisation(STPD).METHODS We conducted a single-centre retrospective study of 1045 PH patients treated with either SSPD(S Group, 357 patients) or STPD(T Group, 688 patients) between January 2002 and February 2017. In all, 37 clinical indicators were compared to evaluate the efficacy of SSPD.RESULTS Perioperative indicators in the S Group were significantly better than those in the T Group(P < 0.05). In both groups, the postoperative long-term portal vein diameter and Model for End-Stage Liver Disease score were significantly lower than those in the preoperative and postoperative short-term groups(P< 0.05). The incidence of complications in the S Group was significantly lower than that in the T Group(P < 0.05). Compared to the T Group, postoperative shortterm WBC(white blood cell) and platelet counts were significantly lower and the short-term Hb(haemoglobin) level was significantly higher in the S Group(P < 0.05). In the S Group, postoperative long-term total bilirubin, direct bilirubin, alanine transaminase, and aspartate transaminase and postoperative serum creatinine and cystatin C levels were significantly lower than those in the T Group(P < 0.05), and postoperative albumin was significantly higher than that in the T Group(P < 0.05).CONCLUSION Compared to STPD, SSPD is a simple and easy procedure resulting in less tissue damage. Patients recovered smoothly and steadily with fewer complications. Short-term liver and kidney function damage was less severe, and long-term liver function recovery was better. Therefore, SSPD is worthy of clinical promotion and application for the treatment of PH.AIM To compare the clinical outcomes of patients with portal hypertension(PH) who underwent treatment with splenectomy plus simplified pericardial devascularisation(SSPD) or splenectomy plus traditional pericardial devascularisation(STPD).METHODS We conducted a single-centre retrospective study of 1045 PH patients treated with either SSPD(S Group, 357 patients) or STPD(T Group, 688 patients) between January 2002 and February 2017. In all, 37 clinical indicators were compared to evaluate the efficacy of SSPD.RESULTS Perioperative indicators in the S Group were significantly better than those in the T Group(P < 0.05). In both groups, the postoperative long-term portal vein diameter and Model for End-Stage Liver Disease score were significantly lower than those in the preoperative and postoperative short-term groups(P< 0.05). The incidence of complications in the S Group was significantly lower than that in the T Group(P < 0.05). Compared to the T Group, postoperative shortterm WBC(white blood cell) and platelet counts were significantly lower and the short-term Hb(haemoglobin) level was significantly higher in the S Group(P < 0.05). In the S Group, postoperative long-term total bilirubin, direct bilirubin, alanine transaminase, and aspartate transaminase and postoperative serum creatinine and cystatin C levels were significantly lower than those in the T Group(P < 0.05), and postoperative albumin was significantly higher than that in the T Group(P < 0.05).CONCLUSION Compared to STPD, SSPD is a simple and easy procedure resulting in less tissue damage. Patients recovered smoothly and steadily with fewer complications. Short-term liver and kidney function damage was less severe, and long-term liver function recovery was better. Therefore, SSPD is worthy of clinical promotion and application for the treatment of PH.

关 键 词：Simplified PERICARDIAL devascularisation Clinical OUTCOME SPLENECTOMY PORTAL HYPERTENSION 

分 类 号：R[医药卫生]