Abstract:

The incidence of hepatitis B and schistosomiasis is higher in China, as a result the incidence of portal hypertension in China is significantly higher than it in Europe and USA. It is very important to prevent and treat the portal hypertension in China. Traditional surgical treatments on portal hypertension include devascularization and shunt procedure. The devascularization is a relatively simpler surgical procedure. Its disadvantages include higher perioperative death(10%～20%) and higher recurrent bleeding rate(significantly higher than shunt procedure). The portacaval shunt plus enhancement of perfusion of hepatic artery can increase the perfusion of hepatic artery, maintain the liver function and overcome the side effects of the portacaval shunt. The liver transplantation is the only curative method for the liver cirrhosis and portal hypertension, but in our country it is not impractical to treat all patients with portal hypertension and variceal bleeding of esophago-fundus of stomach resulting from the posthepatitic cirrhosis and the schistosomiasis using liver transplantation. The traditional surgical treatments in China still play an important role in a long term in the future. The higher cost of liver transplantation is also a bigger problem. It should be seriously studied the investing more money for developing liver transplantation or for preventing and treating hepatitis and schistosomiasis.

Key words: devascularization, portal hypertension, portacaval shunt, enhancement of perfusion, liver transplantation