目的:探讨二级脾蒂离断术在门静脉高压病人脾切除术中的作用。方法:比较分析1999-2005年浙江大学医学院附属第二医院在门静脉高压病人行脾切除加贲门周围血管离断术中二级脾蒂离断术(离断组)与传统脾切除术(传统组)的临床资料。结果:离断组脾热、胰漏的发生率及术后住院时间低于传统组；出血量及手术时间两组差异无显著性意义。发生胰漏、脾热者多为脾大的病人。结论:二级脾蒂离断术可降低门静脉高压脾切除病人脾热、胰漏的发生率，减少术后住院时间，是一种值得推广的手术方式，尤其对于脾脏较大的病人。

Objective:Evaluate the value of technique of spleen subpedicle severance for splenectomy in portal hypertension patients. Methods:Compare stay time,operation time,blood loss volume,incidence rate of complication between spleen subpedicle group and control group in portal hypertension patients with splenectomy and Pericardiac devascularization.and analysis the relationship between complication and spleen size. Results:The incidence rate of spleen fever,pancreas leakage and stay time are higher in control group than in test group.The operation time and blood loss volume are no significantly different in two groups.Spleen size in patients with spleen fever or pancreas leakage is thicker than in patients without spleen fever or pancreas leakage. Conclusion:The technique of spleen subpedicle severance can decrease incidence rate of spleen fever,pancreas leakage and shorten stay time in portal hypertension patients with splenectomy and Pericardiac devascularization.It is a value operation technique especially for patients with large spleen.