Related Experiment Video

Updated: Feb 12, 2026

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
04:00

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension

Published on: November 15, 2024

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The therapeutic effect of splenectomy plus selective pericardial devascularization versus conventional pericardial

Yajie Zhao1, Chengfeng Wang1

  • 1Department of Pancreatic and Gastric Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

Oncotarget
|April 11, 2018
PubMed

Insights

Selective extrahepatic devascularization (s-EGDV) with splenectomy is more effective than non-selective extrahepatic devascularization (n-sEGDV) for treating portal hypertension, reducing complications and improving outcomes.

Area of Science:

  • Gastroenterology and Hepatology
  • Surgical Oncology
  • Vascular Surgery

Background:

  • Portal hypertension with thoracic esophageal varices and bleeding presents significant clinical challenges.
  • Current surgical strategies aim to reduce portal pressure and prevent variceal bleeding.

Purpose of the Study:

  • To systematically review and meta-analyze perioperative outcomes and postoperative complications of splenectomy plus selective extrahepatic devascularization (s-EGDV) versus non-selective extrahepatic devascularization (n-sEGDV).
  • To compare the efficacy and safety of s-EGDV and n-sEGDV in managing portal hypertension.

Main Methods:

  • A comprehensive literature search was conducted across major databases (PubMed, Cochrane Library, Web of Science, EMBASE, TCGA, Chinese Biomedicine Database) from January 2000 to June 2017.
  • Included studies were randomized controlled trials (RCTs) and non-randomized observational clinical studies (OCS) comparing s-EGDV and n-sEGDV.
  • Study selection and data extraction were performed by two independent investigators.

Main Results:

  • The meta-analysis included 7 RCTs and 7 OCS.
  • s-EGDV demonstrated significant benefits in reducing portal vein flow (PVF), portal hypertensive gastropathy, hepatic encephalopathy, and postoperative re-bleeding and mortality.
  • s-EGDV also showed an increase in hepatic artery flow compared to n-sEGDV.

Conclusions:

  • Selective extrahepatic devascularization (s-EGDV) combined with splenectomy is a more effective surgical approach for treating portal hypertension compared to non-selective extrahepatic devascularization (n-sEGDV).
  • s-EGDV is associated with fewer postoperative complications and improved patient outcomes.
  • This approach may offer a new direction for surgical management of portal hypertension.
Abstract

Keywords:
meta-analysisnon-selective esophagogastric devascularizationportal hypertensionselective esophagogastric devascularization

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