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目的 总结139例采用食管吻合器的断流术经验，并观察治疗门静脉高压症的疗效。方法 对139例肝硬化性门静脉高压症采用食管吻合器的联合断流术治疗。结果 无手术死亡。腹腔内继发性出血2例（1．44％），肺不张和肺部感染各1例（0．72％），脾静脉血栓3例（2．16％），无食管吻合口瘘和吻合口狭窄。肝性脑病发生率0．72％（1／139）；再了血率2．16％（3／139）；手术1－3个月后，97例术前肝功能属Child-Pugh B级者有，76例转为A组；71例于术后半年接受过胃镜或食管吞钡检查，食管胃底曲张静脉消失者43例（60．56％），显著改善者27例（38．03％），无变化者1例（1．41％）。结论 应用食管吻合器的联合断流术治疗肝硬化性门静脉高压症的疗效较好，再出血率低，并发症少，是一种值得推广的治疗门静脉高压症的方法。

Analysis of 139 cases treated with esophagus stampler combined with devascularization

Objective To review the experience and to evaluate the effect of extensive esophagogastric devascularization combined with esophageal transection, splenectomy and reanastomosis of the distal esophagus with a circular stampler in the treatment of portal hypertension for 139 cases. Methods This method was performed in 139 patients suffering from portal hypertension secondary to liver cirrhosis.Results There was no operative mortality.The operative complications were 2 cases(1 44%) of secondary intra-abdominal bleeding,1 case(0 72%) of drowned lung,1 case(0 72%) of pneumonia,and 3 cases(2 16%) of splenic venous thrombosis,and no esophageal anastomotic leakage and stenosis.One hundred and thirty-eight out of 139 (99%) were followed-up with a mean follow-up time of 5 years and 2 months.Hepatic coma and rebleeding rate were 0 72%(1/139) and 2 16%(3/139) respectively.In 76 out of 97(78%) patients,their liver functions changed better from Child-Pugh grade B to A in first to third month after operation.In 71 patients receiving gastroscopy (57 cases) or esophageal barium photography (24 cases) six months later after operation,the gastro-esophageal varices disappearance rate was 60 56%(43/57),obvious improvement rate was 38 03%(27/57),only one patient(1 41%) had no change for esophageal varices.Conclusion In treatment of portal hypertension following hepatic cirrhosis,the effect of modified Sugiura procedure with esophagus stampler is very satisfactory with a low complication rate and low bleeding recurrence,and it can be used widely.