To summarize and analyze the efficacy by observing the short-and long-term follow-up of patients undergoing splenectomy for hypersplenism with portal hypertension.

Clinical data of 351 cases was collected involved in portal hypertension and hypersplenism. The reviewed parameters included the occurrence of postoperative infection, emergence of secondary hepatic cancer, changes of liver functions and peripheral blood cells, and the condition control of diabetes mellitus, cardiovascular system and alimentary system diseases.

After resection of the pathologic spleen, the functions of injured liver and blood cells count gradually improved and recovered to normal levels in a short period. The short-term complications, mainly including 42 cases with jaundice, 31 with ascites, 34 with fever, and 13 with rehaemorrhagia of upper gastrointestinal tract, alleviated by prompt symptomatic treatment. In the long-term follow-up of 87 cases, 29 were detected declined liver functions, decreased serum albumin, and increased transaminase about 2~33(medians 11.4) months postoperatively. 6 cases had a secondary liver cancer, 4 patients died and there was no overwhelming postsplenectomy infection (OPSI). Furthermore, the condition control of diabetes mellitus, cardiovascular system and alimentary system disease obviously improved after splenectomy.

Splenectomy has both advantages and shortcomings for patients of hypersplenism with portal hypertension and needs further exploration.