Treatment of portal hypertension with combined vagus trunk-preserving portoazygous devascularization and shunting: Report of 28 cases

ObjectiveTo investigate the therapeutic outcome of surgical intervention with combined vagus trunk-preserving portoazygous devascularization and shunting (VTPPDS) to treat patients with portal hypertension. MethodsThe clinical data of portal hypertension patients who underwent VTPPDS (n=28) or portoazygous devascularization in combination with pyloroplasty (PD+PP; n=30) in our hospital from 2005 to 2011 were collected for comparative analysis. The statistical significance of differential rates of gastroenteric function recovery (within 72 hrs post-surgery), postoperative ventosity and postoperative hemorrhage, status of ascites, and length of hospital stay (discharge within 14 days) were compared between the two groups using the Chi-squared test. ResultsIn the VTPPDS group, 27 patients were cured and one patient died of liver failure. When compared to the PD+PP group, the VTPPDS group showed significantly earlier recovery of gastroenteric function (60.0% vs. 85.7%, P＜0.05), lower incidences of postoperative ventosity (43.3% vs. 7.1%, P＜0.01) and postoperative hemorrhage (26.7% vs. 7.1%, P＜0.05), higher incidences of ascites reduction/disappearance (62.5% vs. 95.5%, P＜0.01), and shorter length of hospital stay (53.3% vs. 78.6%, P＜0.05). ConclusionThe VTPPDS procedure is an effective surgical method to treat portal hypertension, and provides superior post-operative outcomes to the PD+PP procedure.