Abstract:Objective:To compare prospectively the features and effects of combined operation (splenorenal shunt plus portal-azygous devascularization) and portal-azygous devascularization only（PCDV）on portal hypertension(PH). Methods:We summarized 360 cases of PH admitted from 1984 to 2004. All patients were randomly divided into two groups, one was combined operative group (250 patients) and the other was PCDV group (110 patients). The therapeutic effects and changes of portal hemodynamics were studied with doppler flowmeter(DCFI), free portal pressure(FPP) and digital subtraction angiography (DSA) pre-and post-operatively, and were measured directly during the course of the procedure. Results:(1)Postoperative bleeding:Of all the patients who underwent combined operation, no case of rebleeding occurred in the short period after operation, and the rebleeding rate was 8.0% in the long period of follow-up. In the patients who underwent PCDV, the rebleeding rate was 5.5% in the short period after operation, and 17.6% at long-term follow up(P<0.05) postoperatively. (2)The rate of hepatic encephalopathy in the combined operation group was 5.6% and in the PCDV group aws 4.4%(P>0.05). (3)There was a significant decrease in the diameter of portal vein, and FPP postoperatively in the combined operation group compared to PCDV group. There was a significant decreases of PVF in the PCDV group. But the decrease of PVF in the two groups had no significant difference. Conclusions:The combined procedure has merits of greater decrease of FPP, and alleviation of the condition of hyperdynamic blood flow in the portal vein. The clinical effect is also better than that of portal-azygous devascularization only.