Treatment of portal hypertension and hypersplenism by distant splenorenal venous shunt operation combined with partial splenectomy        WANG Qing, DONG Rui, DU Xi-lin，et al. Department of General Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi’an 710038, China
Corresponding author: LU Jian-guo, E-mail:lujguo@fmmu.edu.cn
Abstract    Objective    To compare the effect of distant splenorenal venous shunt operation (Warren’s operation) with distant splenorenal venous shunt operation combined with partial splenectomy in treating portal hypertension and hypersplenism. Methods    The clinical data of 22 cases of portal hypertension and hypersplenism treated by operation with complete follow-up data from 2010 at Tangdu Hospital of the Fourth Military Medical University were analyzed. Twenty-two cases included 8 cases performed distant splenorenal venous shunt operation named Warren group and 14 cases performed distant splenorenal venous shunt operation combined with partial splenectomy named Warren﹢partial splenectomy group. WBC and PLT counts on the 7th and 30th day after surgery and IgG,IgA and IgM on the 30th day after surgery between two group were compared. Results    The recovery of WBC and PLT in Warren + partial splenectomy group was better than those in Warren group significantly (P<0.05). Pre and postoperative immunoglobulin test showed that there was no significant difference between two groups (P>0.05). Conclusion    The therapeutic effect of distant splenorenal venous shunt operation combined with partial splenectomy for portal hypertension and hypersplenism is superior to simple distant splenorenal venous shunt operation. The former could both decrease portal pressure and cure hypersplenism with keeping the normal splenic physiological function. However, the proportion of spleen need to be operated on and the indication require individualization. The former need further investigation especially.