Abstract:Objective:To observe the clinical effects of pericardial devascularization(Hassab operation) combined with endoscopic variceal ligation(EVL) in the treatment of esophageal variceal bleeding(EVB) in portal hypertension and to discuss its rationality.Methods:The clinical data of 93 patients with EVB admitted in the recent 5 years being randomly divided into undergoing one of three surgical procedures including EVL,Hassab operation and the combined procedure respectively were analyzed and compared.Results:Acute hemostatic rate of the three procedures had no significant difference（P>0.05）.In the combined procedure group, no short-term bleeding occurred and the incidence of rebleeding was 5.7% during long-term follow-up.The incidence of rebleeding was significantly lower in the combined procedure group than in EVL and Hassab operation group（P<0.05）.Blood flow volume of azygos venous system decreased postoperatvely by 22.7%,30.4% and 45.7% in EVL,Hassab operation and the combined procedure respectively.Conclusions:The combined operation can interrupt abnormal portal-azygous shunts within and outside the gastroesophageal lumen and thus can radically treat esophageal varices and promote the disappearance of hypersplenism, so can significantly decrease azygous venous blood flow. It has the advantage of achieving secure stoppage of bleeding and has a low rate of rebleeding. The combined operation is a rational and feasible operation in the treatment of patients with esophageal variceal bleeding due to portal hypertension.