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[Staple in pericardial devascularization of upper GI bleeding due to portal hypertension: application and therapeutic
1Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, 100730 China.
Objective:
To investigate the therapeutic effect of staple in pericardial devascularization on upper GI bleeding due to portal hypertension.
Methods:
From July, 1997 to July, 2000, 30 portal hypertensive patients were treated by using pericardial devascularization plus partial resection of lower part of the esophagus with staple (CDH25). The eliminating rate of varicose veins of the lower part of the esophagus and the stenosis rate of anastomosis were evaluated. The therapeutic effect of pericardial devascularization without lower part esophageal resection in 28 patient with upper GI bleeding due to portal hypertension was taken as control.
Results:
All the patients were followed up for 23 months. There was no death due to the operation. All patients in the study group had no upper GI rebleeding during the 23-month follow-up. The rebleeding rate in the control group was 18% (5/28) (P < 0.05 vs. Study group). The varicose veins eliminating rate was 100% in the study group and 53.6% (15/28) in the control group (P < 0.01); the stenosis rate of anastomosis was 6.7% (2/30) in the study group.
Conclusion:
The therapeutic effect of pericardial devascularization could be improved by the use of staple with shorter operative time.