A Meta-analyse Of The Subtotal Splenectomy To Treat Portal Hypertension

Objective: To analyze the efficacy of surgical procedures(subtotal splenectomy,total splenectomy combined with gastroesophageal devascularization)in treating patients with PHT(Portal Hypertension).Methods: Related literatures was retrieved from PubMed,Medline,Cochrane library,Embase,CNKI,and a Meta-analysis was carried out by using Revman5.3 to assess the efficacy of the two different surgical procedures.Results: A toal of 12 trials were finally identifided using predetermined inclusion criteria.The Meta-analysis showed that there is a lower risk in the subtotal splenectomy of postoperative fever and portal vein thrombosis(P < 0.05),and the increase of postoperative platelet was smaller(P < 0.05),which was more likely to bleed(P < 0.05).There was no statistical significance in postoperative infection,hepatic encephalopathy and other complications(P > 0.05).After subtotal splenectomy,the Tuftsin and IgM values of serum were higher(P < 0.05),while there was no statistical significance besides the two different surgical procedures(P > 0.05).There was no statistical significance in FPP(Free Portal Vein Pressure)between the two groups(P > 0.05).Conclusion: Compared with total splecectomy combined with gastroesophageal devascularization,there was a higher serum Tuftsin and IgM values,lower serum platelet,smaller risk ofportal vein thrombosis,but a higher risk of bleeding in patients which got subtotal splenectomy.