吻合器联合门奇静脉断流加脾肾静脉分流治疗门脉高压症

目的探讨吻合器联合门奇静脉断流加脾肾静脉分流治疗门脉高压症的疗效。方法采用吻合器联合门奇静脉断流加脾肾静脉分流治疗33例门脉高压症并与40例单纯断流术及39例吻合器加断流术进行比较。结果临床疗效满意，术后近期无一例再出血，远期仅1例再出血，术后无一例发生吻合口溃疡、狭窄、梗阻及吻合口漏，1例发生肝性脑病。结论吻合器联合门奇静脉断流加脾肾静脉分流术既保留了断流术及分流术的优点，又克服了二者的缺点，是治疗门脉高压症一种合理可行的术式。其远期疗效尚需积累更多的病例和进行更长期的随访进一步观察。

The Clinical Study of Circular Stapler with Esophagogastric Devascularization and Splenorenal Vein Shunt to Cure Portal Hypertension

Objective To investigate the effect of the circular stapler with esophagogastric devascularizationg and splenorenal vein shunt used to cure portal hypertension. Methods Aretrospective analysis was made on the results of 33 patients with liver cirrhosis, portal hypertension esophageal and gastric variceal bleeding who were treated with circular stapler with esophagogastric devascularization and splenorenal vein shunt and made on the 40 patients who get the same disease and treated with esophagogastric desvascularization or circular stapler with esophagogastric devascularization. Results All the patients were followed up for 1 to 4 years. None of the patients occurred to rebleeding shortly after 6 months of operation, and later only one case of rebleeding. There is neither anastonomic stoma, nor stenosis and obstruction of stoma, nor anastonomic leakage after the operation. One patient developed hepatic encephalopathy. Conclusions The circular stapler with esophagogastric devsacularization and splenorenal vein shunt used to cure portal hypertension not only retains the advantages of esophagogastric desvascularization and shunt, but also overcomes their disadvantages. It is a reasonable and available operation to cure the portal hypertension. More cases and further observations are necessary before we see its effect clearly.