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AIM:To evaluate the feasibility of a new strategy ofendoscopic variceal ligation combined with partial splenicembolization(EVL-PSE)for patients with cirrhosis and portalhypertension.METHODS:From May 1999 to May 2002,41 cases withcirrhosis and portal hypertension underwent EVL-PSE.Hemodynamics of the main portal vein(MPV),the left gastricvein(LGV)and azygos vein,including maximum velocity,flow rate and vein diameter,were assessed by Dopplerultrasonography.RESULTS:One case died from pulmonary artery embolism.One case complicated with splenic abscess was successfullymanaged by laparotomy.The esophageal varices andhypersplenism were well controlled after EVL-PSE in otherpatients.After EVL-PSE,the flow rate and velocity of MPVwas significantly reduced(P<0.05),as well as the flow rateof the LGV and azygos vein.During the follow-up,norecurrent bleeding was found.CONCLUSION:Being more convenient and less invasive,EVL-PSE is hopeful to be a proper intervention strategy forportal hypertensive patients with impaired hepatic functionor those intolerant to shunting or devascularization surgery.
AIM: To evaluate the feasibility of a new strategy of endoscopic variceal ligation combined with partial splenicembolization (EVL-PSE) for patients with cirrhosis and portal hypertension. METHODS: From May 1999 to May 2002, 41 cases withcurrent and portal hypertension underwent EVL-PSE.Hemodynamics of the main portal vein (MPV), the left gastricvein (LGV) and azygos vein, including maximum velocity, flow rate and vein diameter, were assessed by Doppler ultrarasonography.RESULTS: One case died from pulmonary artery embolism. One case complicated with splenic abscess was successfullymanaged by laparotomy.The esophageal varices andhypersplenism were well controlled after EVL-PSE in otherpatients. After EVL-PSE, the flow rate and velocity of MPV was significantly reduced (P <0.05), as well as the flow rateof the LGV and azygos vein . Playing the follow-up, norecurrent bleeding was found. CONCLUSION: Being more convenient and less invasive, EVL-PSE is hopeful to be a proper intervention strategy for portal hypertensive pa tients with impaired hepatic functionor those intolerant to shunting or devascularization surgery.