A Comparative Study On Two Types Of Extensive Devascularization Around The Cardia

Objective:Probe into the clinical effect of extensive devascul- arization around the cardia plus gastric fundus purse string suture in the treatment of the upper gastrointestinal hemorrhage of portal hypertensionMethords:The clinical data of 140 cases of upper gastrointestinal hemorrhage of portal hypertension treated by using porta - azygous devascularization from January 1998 to October 2008 were analyzed retrospectively.Patients were allocated into traditional group(18 cases) which treated with simple extensive devascularization around the cardia and modify group(122 cases) which treated with extensive devascularization around the cardia plus gastric fundus purse string suture.Changes of liver function after operation, the incidence of perioperative complications and the incidence of forward upper gastrointestinal rebleeding were compared between the two groups.Results:The changes of liver function after operation in modify group had no statistical significance,compared with the traditional group also had no statistical difference. The incidence of perioperative complications like ascites, hepatic encephalopathy, upper gastrointestinal rebleeding ,intra-abdominal hemorrhage, incision infection in modify group as compared with traditional group had no statistical difference. And compared the forward upper gastrointestinal rebleeding after operation between the two groups, The recurrent bleeding rate of modify group was 12.1%,anf the bleeding duo to the varicose vein only had 4.7%.This proportions were much lower than the one in the traditional group(33.3% and 22.2%).The Differences between the two groups had had no statistical significance. By comprehensively analyzing the clinical data we know that compared with simple extensive devascularization around the cardia, after plus gastric fundus purse string suture have no more operative trauma,no more postoperative complications,and much lower incidence of forward upper gastrointestinal rebleeding.Conclusion:The improved operation extensive devascul- arization around the cardia plus gastric fundus purse string suture that not only accord with the requirements to porta - azygous devascularization of the mordon medicine as exact hemostasis, prevent rebleeding, reduce hepatic injury,but also has superiority of lower postoperative complications, lower hospitalization time and hospitalization expenses.The surgical procedure is very simple and easy to master. So this operation type is suitable for clinical expansion.