选择性门奇断流加贲门周围腹膜化治疗食管胃底曲张静脉出血21例

采用选择性门奇断流加贲门周围腹膜化治疗食管胃底曲张静脉出血２１例。手术方法为脾切除和仅切断进入胃和食管的出血性门静脉分支，对食管、胃外的门奇交通支予以保护，断流后利用胃底部包绕贲门和食管下段，使贲门周围腹膜化以阻止新生血管重新长入和避免再出血。经３个月至３．５ａ随访，仅１例再出血，无肝性脑病发生，患者的生活质量明显提高。结果提示该方法是治疗门脉高压症食管胃底曲张静脉出血的一种较好的措施。

Treatment of bleeding gastroesophageal varice with selective porta-azygous devascularization and peritonization

The treatment of 21 cases of bleeding gastroesophageal varices with selective portaazygous devascularization and pericardial peritonization is reported in this paper.The procedure consisted of spleenectomy and selective excision of bleeding gastroesophageal varice. After porta-azygous devascularization, the cardia and lower esophagus were enbeded by the fundus of the stomach. So the communicating branchs of the porta-azygous veins outside of the stomach and the esophagus were protected,and the pericardial area was peritonized to prevent the neoformative blood vessels from growing into it and leading to recurrent bleeding. 3 months to 41 months follow-up demonstrated that only 1 case had recurrent bleeding,that no hepatic encephalopathy occurred,and that the patient's conditions were markedly improved.The preliminary results show that this procedure is a good method for the treatment of bleeding gastroesophaeal varices due to portal hypertension.