How to reduce the risk of postoperative bleeding in portal hypertension?

  In patients with cirrhotic portal hypertension, when there is upper gastrointestinal bleeding (bleeding from ruptured esophagogastric fundic veins), splenectomy with flow dissection is often required. Although the bleeding can be stopped by transfusion of blood, plasma, and clotting factors, the author feels that if effective methods of hemostasis are used during surgery, the amount of postoperative bleeding can be greatly reduced, thus reducing the chance of liver failure and renal failure, and increasing the safety of the patient undergoing surgery.  The author’s insights: 1. The spleen was cut using the secondary splenic tee dissection method.  2, the trauma is hemostatic using Prilene sutures and less hemostatic using electric knife cautery.  Other surgical techniques should be mastered by general surgeons: first ligating the splenic artery and massaging the spleen to allow blood to return to the spleen. The gastric lesser curvature is dissected in two separate layers, anterior and posterior, etc.