Abstract：
Some patients with refractory esophagogastric varices require surgery, such as gastric devascularization and splenectomy (Hassab\'s procedure). However, these patients are at risk of perioperative morbidities when undergoing devascularization to develop collateral vessels. We performed a more simplified procedure, splenectomy, and en bloc gastropancreatic fold division (GPFD) with hand-assisted laparoscopic surgery. Four patients with refractory esophagogastric varices and portal hypertension underwent splenectomy and GPFD. We reviewed patients\' perioperative laboratory and morphological data, operative variables, and postoperative outcomes. Esophagogastric varices improved in 3 (75%) of the 4 patients. In one patient, esophageal varices (F1RC0) were observed 3 years after surgery, but they required no treatment and only received follow-up. Treatment with splenectomy and GPFD is not only less invasive than Hassab\'s procedure but also provides effective outcomes for refractory esophagogastric varices.
摘要：
一些难治性食管胃静脉曲张患者需要手术，如胃血管断流术和脾切除术（Hassab手术）。然而,这些患者在进行血管离断术以形成侧支血管时,有发生围手术期并发症的风险.我们做了一个更简化的程序,脾切除术,手助腹腔镜手术和整块胃胰腺折叠部（GPFD）。4例难治性食管胃静脉曲张和门静脉高压症患者接受了脾切除术和GPFD。我们回顾了患者围手术期实验室和形态学数据，操作变量，和术后结果。4例患者中有3例（75％）食管胃静脉曲张得到改善。在一个病人中,术后3年观察食管静脉曲张（F1RC0），但他们不需要治疗，只接受随访。脾切除术和GPFD治疗不仅比Hassab手术侵入性小，而且对难治性食管胃静脉曲张提供了有效的结果。
