Therapeutic effects and complications of simplified pericardial devascularization for patients with portal hypertension

摘要

Objectives: To evaluate the therapeutic effects and complications of simplified pericardial devascularization for patients with portal hypertension. Methods: By means of prospective study, 212 patients who underwent simplified pericardial devascularization (Group A) and 309 patients who underwent traditional pericardial devascularization (Group B) were followed up from 2003’ to 2011’. Results were performed with the general condition of the patients and the incidence of complications to assess the value of the two operating methods. Results: The operating time was 1.0-3.83 hours (mean 1.94 ± 0.32 hours) in Group A versus 1.67-4.50 hours (mean 2.86 ± 0.40 hours) in Group B. The amount of bleeding, postoperative hospital stay and hospitalization expenses were 110-500 ml (mean 224.81 ± 78.44 ml), 7-22 days (mean 10.41 ± 4.01 days) and 15700-27500 yuan with an average of 19300 ± 1600 yuan in Group A and 200-700 ml (mean 423.50 ± 85.19 ml), 9-32 days (mean 14.76 ± 4.52 days) and 18700-44500 yuan with an average of 23400 ± 2200 yuan in Group B. In September 2012’, successful follow-up was completed for 438 patients, of which, 181 underwent the simplified devascularization with 31 patients lost (follow-up rate 85.4%). Meanwhile, 257 patients in Group B were followed up completely and 52 patients were lost (follow-up rate 83.2%). The follow-up time ranged from 1 to 9.5 years and the average time was 5.03 ± 2.13 years. The mortality, rebleeding rate, rate of hepatic encephalopathy, rate of ascites and the incidence of gastric fistula and (or) esophageal fistula were 6.1%, 6.1%, 1.7%, 8.3% and 0 in Group A versus 14.0%, 15.2%, 4.3%, 17.7% and 3.1% in Group B. Conclusions: The final results suggested that simplified pericardial devascularization performed more effectively and conveniently than the traditional method, depending on the mitigated operative wound and the shortened operation time. We concluded that simplified pericardial devascularization was better in treatment of portal hypertension compared than the traditional method.