Gastroesophageal devascularization vs portasystemic shunt combined with gastroesophageal devascularization for treatment of portal hypertension: a meta-analysis         JIANG An, LI Zong-fang, ZHANG Shu，et al. Department of Surgery, the Second Hospital, Xi’an Jiaotong University, Xi’an 710004, China
Corresponding author: LI Zong-fang, E-mail: lzf2568@mail.xjtu.edu.cn
Abstract    Objective    To systematically evaluate the therapeutic effect of gastroesophageal devascularization (GD) and portasystemic shunt  combined with gastroesophageal devascularization (PSS+GD) of portal hypertension(PHT) after liver cirrhosis. Methods    The literature about the therapeutic effect of GD and PSS+GD on portal hypertension after cirrhosis were collected from Medline, Elsevier, China Biological Medicine Disk and Wanfang data between January, 2002 and November, 2008. RevMan 5.0 software was used for data analysis. Results    According to the included criteria, 7 clinical trials were selected finally.  The combined results of meta-analysis showed that the operative mortality had not significant diffience between the two operation［RR=1.04,95%CI(0.48，2.26),P>0.05］; Recurrent variceal bleeding rates of PSS+GD were lower than GD［RR=3.62,95%CI(2.36，5.55),P<0.05］; Encephalopathy rates were similar ［RR=0.69,95%CI(0.40，1.20),P>0.05］, while post operative mortality between GD and PSS+GD were similar also ［RR=1.18,95%CI(0.79，1.75),P>0.05］.Conclusion    PSS+GD have a better effect on PHT with high rebleeding risk，and GD is suit for most patients with PHT.