Efficacy of pericardial devascularization combined with splenectomy in treatment of patients with portal hypertension

Objective To explore the clinical efficacy of pericardial devascularization (PCDV) combined with splenectomy in the treatment of patients with portal hypertension (PHT) and its influence on perioperative indicators, serum hepatocyte growth factor (HGF) and transforming growth factor-β₁ (TGF-β₁).

Methods Clinical materials of 91 patients were analyzed retrospectively, and the patients were divided into observation group (53 cases, treated with selective PCDV and splenectomy) and control group (38 cases, treated with traditional PCDV and splenectomy) according to different therapeutic methods. The clinical efficacy, surgical condition and incidence of complications were compared between the two groups; the total bilirubin (TBIL), alanine aminotransferase (ALT), serum albumin (ALB) level, prothrombin time (PT), serum HGF and TGF-β₁ before and after operation were compared between the two groups.

Results Improvement of esophagogastric varices (EGV) in the observation group was significantly better than that in the control group, the Child-Pugh score of liver function was significantly lower than that in the control group, and the difference value of free portal pressure (FPP) was significantly higher than that in the control group (P < 0.05); the operation time, intraoperative blood loss, postoperative exhaust time, drainage time and hospital stay in the observation group were significantly less or shorter than those in the control group (P < 0.05). The TBIL, ALT and PT after surgery were significantly lower than those before surgery in both groups, while the ALB was higher than that before surgery (P < 0.05); the level of serum HGF after in the observation group was significantly higher than that in the control group, while the TGF-β₁ was significantly lower than that in the control group (P < 0.05). Within 3 months after operation, no pancreatic fistula, splenic abscess and hepatic encephalopathy occurred in both groups, and the incidence rates of fever and gastrointestinal rebleeding in the observation group were significantly lower than those in the control group (P < 0.05).

Conclusion Selective PCDV combined with splenectomy is better than traditional non-selective PCDV combined with splenectomy in the treatment of PHT, which can enhance the ability of hepatocyte regeneration, improve liver dysfunction, and reduce the incidence of complications such as postoperative fever and gastrointestinal rebleeding.