Therapeutic effects of endoscopic variceal ligation combined with partial splenic embolization for portal hypertension

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.