Impact of devascularization of postpancreatic varices on free portal pressure of patients with portal hypertension

Abstract

Objective To investigate the impact of devascularization of postpancreatic varices on free portal pressure (FPP) of patients with portal hypertension.Methods The clinical data of 135 patients with portal hypertension who received splenocaval shunt + devascularization of postpancreatic varices at the Shaanxi Provincial People's Hospital from January 1997 to December 2007 were retrospectively analyzed.The changes of FPP of 60 patients before and after devascularization of postpancreatic varices were detected.The 60 patients were divided into variceal group (36 patients) and non-variceal group (24 patients).The FPP of variceal group at different time points was compared by using the t test,and the difference in FPP between the 2 groups was compared by using the independent samples t test.Results The incidence of varices of retroperitoneal and collateral veins was 68.1％ (92/135),and patients with types Ⅰ,Ⅱ,and m were accounted for 73.9％ (68/92),6.5％ (6/92) and 19.6％ (18/92),respectively.After devascularization of the postpancreatic varices,the FPP of the variceal group was (36.5 ± 2.1) cm H2O (1 cm H2O =0.098 kPa),which was significantly higher than (34.1 ± 2.0) cm H2O before devascularization (t =4.97,P ＜ 0.05) and (33.3 ± 2.6) cm H2O of the non-variceal group (t =5.25,P ＜ 0.05).Conclusions The incidence of varices of postpancreatic veins is high.Devascularization of these variceal veins could increase the FPP. Key words: Portal hypertension; Splenocaval shunt; Retroperitoneal veins; Retroperitoneal collateral veins