In situ subtotal spleen resection combined with selective pericardial devascularization for the treatment of portal hypertension

Figure 1 Open surgery of patient. A: Ischemia line is clear on the splenic surface; B: The appearance of the preserved lower pole of the spleen is good, and blood supply is from the splenocolic ligament; C: The upper pole and the lower pole of the spleen are preserved at the same time during the operation; D: The spleen tissue at the splenic hilum was preserved during the operation.

Figure 2 Peripheral blood platelet level and perioperative portal system thrombosis. A: The free portal vein pressure after subtotal splenectomy decreased significantly after surgery (^bP < 0.01 vs pre-operation); B: The platelet level increased significantly 1 mo after subtotal splenectomy. (^cP < 0.001 vs pre-operation); C: The platelet level after subtotal splenectomy increased more slowly than that after total splenectomy (^aP < 0.05, ^cP < 0.001 vs subtotal splenectomy).

Figure 3 Computed tomography images. A: Abdominal computed tomography showed small-scale necrosis of the residual spleen; B: New collateral circulation formed between the residual spleen and retroperitoneal tissue; C: Residual spleen showed obvious hyperplasia 11 years after the operation.