Chinese Medical Journal

SS Sere

PORTAL HYPERTENSION 51

Table 16. The results of postoperative follow-up examination. of liver function

Vo~ Duration of postoperative follow up = OFS Cases~ Within 1-3 3-6 6-12 1-2 2-3 More than

Results “_ 1 month months months months years years 3 years Improved 3 6 5 2 3 1 1 Worsened 15 3 Not changed 7 3 Normal 4 1 1 at 3

- Total 29 13 6 4 6 1 1

finite improvement of the liver function in most of the cases observed over a long period. The number of our cases is small and the results are certainly inconclusive. However, our observations suggest that splenectomy can reduce portal pressure on the one hand and currect anemia on the other, and that it provides beneficial effects to the liver by lessening its venous stasis and improving its nutrition, thus facilitating the regeneration of the liver cells.

e. Effects on symptoms. Twenty-one of the splenectomy cases were followed up from five months to three years. Among them, 11 cases were followed up from five months to one year and 10 cases from one year to three years (Table 17). Aside from the case in which the patient succumbed from hematemesis on the twenty-fourth postoperative day, there was only 1 case in which hematemesis recurred twice one and half years after operation and each time the bleeding stopped after conservative treatment. We feel that when abundant big collaterals are present in the abdominal wall or around the spleen, hematemesis is likely to recur after simple splenectomy without a shunt procedure.

Table 17. The results of postoperative follow-up examination of patients

Hematemesis Ascites Duration of Total R d rati Present Recurred Present ecurre Hgstobera tive Ooms before after before after follow up cases operation operation operation operation 5 months to 1 year 11 4 0 6 0 1 year to 3 years 10 3 1 4 o*

*Tn one case severe ascites developed after operation, but when the patient was examined one year and two months later ascites had entirely disappeared.

As to the effect on ascites, the results appear to be quite satisfactory (Table 17); but, except in 2 cases, the amount of fluid present before operation was small. It is hard to conclude that splenectomy alone can produce favorable result on ascites. In fact, we feel that if the liver dam-