Abstract: Objective The aim of this study was to compare efficacy selective decongestive devascularization of gastrosplenic region (SDD-GSR) and splenectomy and pericardial devascularization (SPD) combination in the treatment of cirrhotics with portal hypertension (PHT). Methods Sixty-five patients with cirrhotic PHT were encountered in our hospital between January 2019 and January 2024, and out of them, 32 patients in observation group received SDD-GSR and 33 in control received SPD. Portal vein pressure was measured by glass water column manometer through right gastroepiploic vein. Portal vein flow (PVF), portal vein diameter (PVD) and portal vein velocity (PVV) were determined by color Doppler ultrasound. Peripheral blood T lymphocyte subsets were detected by flow cytometry. Results By end of surgery, the portal vein pressure in the observation group was (21.1±4.2) cmH₂O, much lower than [(25.7±5.3) cmH₂O, P<0.05] in the control group; by end of three months after operation, the PVD in the observation was (1.3±0.3)cm, much smaller than [(1.5±0.4)cm, P<0.05], while the PVV was (47.7±3.5)cm/s, much quicker than [(41.0±3.1)cm/s, P<0.05] in the control; before and after operation, there were no significant differences as respect to liver function tests and blood cell counts between the two groups (P>0.05); by three months after operation, percentage of peripheral blood CD4⁺ cells and CD4⁺/CD8⁺ cell ration in the observation group were (41.9±3.4)% and (1.4±0.3), both significantly higher than [(35.6±3.1)% and (1.2±0.2), respectively, P<0.05] in the control group. Conclusion The SDD-GSR operation has a satisfactory efficacy in the treatment of cirrhotic PTH, with improvement of portal vein hemodynamics and immune functions, which warrants further clinical investigation.

Key words: Liver cirrhosis, Portal hypertension, Selective decongestive devascularization of gastrosplenic region, Splenectomy and pericardial devascularization, Therapy