The Diagnos And Surgical Treatment Of17Cases With Portal Vein Cavernous Transformation

Objective:to explore the clinical characteristics,diagnosis, surgical treatment experience and compare the curative effect of devascularization with bypass that children with portal vein cavernous transformation.Methods:retrospective analysis17cases children with portal vein cavernous transformation diagnosed and treatment in our hospital between January2003and December2013. Analysis the age, diagnosis, surgical treatment and prognosis of them. A chi-square statistics used to P<0.05for the test of significance level.Results:Surgical treatment can obviously reduce portal hypertension. Around17cases children treated with surgery, there are4cases postoperative bleeding,1case die of postoperative bleeding in6cases underwent cardiac blood vessels. There are1case postoperative bleeding in7cases spleen renal vein bypass surgery. There are1case postoperative bleeding in2block split joint surgery.2cases routine spleen vena cava shunt surgery have no postoperative bleeding. The bleeding rate of devascularization and bypass surgery is11.1%,66.7%respectively, two groups of children with bleeding rate difference is significant (P=0.029). The bleeding rate of children less than or equal to9years old and older than9years old is71.4%,11.1%respectively, two groups of children with bleeding rate difference is significant (P=0.013).Conclusion:devascularization and bypass surgery is an effective method for treatment of portal hypertension.Postoperative bleeding rate with devascularization is much higher than bypass surgery.It has better effect of operation with older children than small age children t. Surgical treatment of CTPV should reduce portal vein pressure, the childrens with splenic vein>1.0cm can ues devascularization;children with spleen vein<1.0cm should add bypass surgery rather than devascularization simply.