限制性门腔静脉侧侧分流并脾动脉、冠状静脉结扎术治疗门脉高压症

自１９８３年５月至１９９３年５月施行限制性门腔侧侧分流并脾动脉、冠状静脉结扎术治疗肝硬化引起的门脉高压症６２例。经随诊，累积死亡率５．３％，上消化道再出血率８．８％，脑病发生率８．８％，优于同期其他分流术。此术式的优点：（１）吻合口直径限制在０．９～１．１ｃｍ，术后防止吻合扩大；（２）限制性分流与断流相结合既降低了门脉高压、防止了食管静脉曲张出血，改善了脾功能亢进，又保留了脾脏；（３）手术创伤小、术后恢复快，平均住院１４ｄ。

Results of limited side-to-side portacaval shunt with ligations of splenic arteryand gastric coronary vein

Frorn May,1983 to May,1993,limited side-to-side portacaval shunt with ligations of splenicartery and gastric coronary vein was performed on 62 patients.All these patients had suffered from varicealhemorrhage secondery to portal hypertension caused only by portal cirrhosis. According to Child's classifica-tion. There were 29 cases in class A and 33 in class B. All the patients survived the operation,and 57 pa-tients were followed up(91.9%).The average tirne of postoperative follow-up was 4 years and 2 months.The 5-years survial rate was 87.5%.The rebleeding rate was 8.8%,and the shunt-related encephalopathyrate was also 8.8%.We conclude that the combined Operation is the procedure of choice for treatment ofvariceal bleeding secondery to portal hypertension,especially for prevention of post-operative shunt-relatedencephalopathy, and for the control of congestive splenomegaly without splenectomy.