Effects of different surgical modality on portoazygous collateral circulation / 中国普通外科杂志

ABSTRACT

Objective To assess the effect of different treatment complex on portoazygous shunt in portal hypertensive patients. Methods Patients (115 cases) with esophageal varices were randomized to receive either endoscopic variceal ligation ( EVL) alone (54 cases ) , pericardial devascularization procedure (PDP) alone(30 cases) or a combination of EVL and PDP(31 cases) for variceal eradication. Esophageal vascular structures were examined with miniature ultrasonic probe and azygos blood flow (ABF) was measured with color Doppler ultrasonography. Results Esophageal varices were obliterated and collateral veins remained unchanged in patients treated by EVL, esophageal varices were diminished in size and collateral veins were obliterated by PDP and both esophageal varices and collateral veins were obliterated by the combination of EVL and PDP. EVL,PDP alone and a combination of the two modalities decreased ABF by 31% ,32% and 43% respectively. Conclusions The combination of EVL and PDP most effectively blocks esophageal collateral shunts.