Scop: Analiza beneficiilor splenectomiei asociata cu endoterapie perioperatorie pentru pacientii cirotici cu hipertensiune portala (HTP), varice esogastrice (VEG) tratati in Clinica si urmariti timp de 3 ani. Material si metoda: Retrospectiv, la vizitele regulate , au fost evaluati pacientii cirotici chirurgical asistati in Clinica la care s-au analizat datele clinico-biologice si endoscopice (incidenta varicelor reziduale / recurente /epizoade hemoragice). Rezultate: Am evaluat datele a 214 pacienti cirotici (86 barbati si 29 femei, cu o vârsta medie de 45 ± 7,9 ani) care au suferit devascularizare azygoportala Hassab / splenectomie; preoperator,un procent de 63,9% cu risc inalt hemoragic, au avut ligatura variceala endoscopica (LVE). Mortalitatea, in decurs de 3 ani dupa operatie,– 16 cazuri (7,5%), din care 11 cazuri prin insuficienta hepatica progresiva. 87(40,7%) pacienti au avut una sau mai multe complicatii legate de ciroza si HTP; 52,8% cazuri din ele - functional au fost reincadrate in stadiul III si IV Baveno, 1 caz a dezvoltat carcinom hepatocelular. In cadrul programului de screening endoscopic s-au documentat 64 cazuri (29,9%) cu recurenta variceala (cu prevalenta de 13,1% pentru sublotul fara LVE preoperatorie). Toti au suferit sedinte profilactice repetate de endoterapie; 37,5% din ele (24 cazuri) au fost asociate cu unul sau mai multe epizoade de hemoragie variceala tratata prin LVE (5 decese). Concluzie: Rezultatele indica avantajul chirurgiei HTP combinate cu endoterapie perioperatorie in comparatie cu metoda izolata de tratamen

Purpose: Analysis of the benefits of combined splenectomy associated with perioperative endotherapy for cirrhotic patients with portal hypertension, esogastric varices (EGV) treated in the Clinic and followed for 3 years. Material and methods: Retrospectively, during regular visits for endoscopy, cirrhotic patients treated in the Clinic were evaluated, where clinical-biological and endoscopic data were analyzed (incidence of residual / recurrent varicose veins / bleeding episodes). Results: We evaluated the data of 214 cirrhotic patients (86 men and 29 women, with a mean age of 45 ± 7.9 years) who underwent Hassab azygoportal devascularization / splenectomy; preoperatively, a percentage of 63.9% with high hemorrhagic risk, had endoscopic variceal ligation (ELV). Mortality, within 3 years after the operation, – 16 cases (7.5%), of which 11 cases due to progressive liver failure. 87(40.7%) patients had one or more complications related to cirrhosis and PH; 52.8% cases from them - functionally were reclassified in stage III and IV Baveno, 1 case developed hepatocellular carcinoma. Within the endoscopic screening program, 64 cases (29.9%) with variceal recurrence were documented (with a prevalence of 13.1% for the subgroup without preoperative LVE). All underwent repeated prophylactic endotherapy sessions; 37.5% of them (24 cases) were associated with one or more episodes of variceal hemorrhage treated by LVE (5 deaths). Conclusion: The results indicate the advantage of surgery combined with perioperative endotherapy compared to the isolated method of treatment.