To compare the clinical efficacy between modified splenopneumopexy and devascularization for cirrhotic portal hypertension.

Clinical data of 60 patients with cirrhotic portal hypertension who underwent surgery in the First Affiliated Hospital of Zhengzhou University between January 2011 and December 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to the surgery procedures, the patients were divided into the modified splenopneumopexy group (n=26) and splenectomy combined with devascularization group (devascularization group, n=34). In the modified splenopneumopexy group, 18 cases were males and 8 were females, aged (41±9) years old on average. In the devascularization group, 22 cases were males and 12 were females, aged (44±8) years on average. Postoperative blood cells and portal venous pressure of two groups were compared using t test. The incidence of complications was compared using Chi-square test.

The free portal venous pressure at postoperative 1 year in the modified splenopneumopexy group was (32.6±1.8) cmH₂O (1 cmH₂O=0.098 kPa), significantly higher than (29.9±2.3) cmH₂O in the devascularization group (t=4.963, P<0.05). The level of WBC, Hb and Plt in the modified splenopneumopexy group was respectively (4.1±1.5)×10⁹/L, (101±18) g/L and (102±40)×10⁹/L, significantly lower than (5.8±1.9)×10⁹/L, (113±16) g/L and (220±70)×10⁹/L in the devascularization group (t=-3.798, -2.588, -8.218; P<0.05). The incidence of portal thrombosis in the modified splenopneumopexy group was 8%(2/26), significantly lower than 29%(10/34) in the devascularization group (χ²=4.344, P<0.05). The incidence of upper gastrointestinal hemorrhage and hepatic encephalopathy in the modified splenopneumopexy group and devascularization group was respectively 15%(4/26), 4%(1/26) and 9%(3/34), 9%(3/34), and no significant differences were observed (χ²=0.143, 0.059; P>0.05).

Compared with the devascularization technique, modified splenopneumopexy has similar clinical efficacy in the prevention and treatment of upper gastrointestinal hemorrhage and hepatic encephalopathy, and has the advantages of lower incidence of postoperative portal venous thrombosis, preserving partial spleen function and higher portal venous pressure which is beneficial to liver perfusion.