Abstract: Objective：To study the clinical effect of laparoscopic highly selective pericardial devascularization combined with splenectomy in the treatment of portal hypertension.Methods：48 patients with portal hypertension were divided into the laparotomy group (open pericardial devascularization) and the endoscopic group (Laparoscopic pericardia devascularization) according to the surgical methods. Each group had 24 patients, and the clinical efficacy of the two groups was observed and compared.Results：After surgery, the decrease of alanine aminotransferase(ALT), aspartate aminotransferase(AST)and total bilirubin(TBIL)in the laparoscopic group(△〖AKX-〗=45.00、△〖AKX-〗=35.59、△〖AKX-〗=25.79) was significantly greater than that of open surgery group(△〖AKX-〗=49.34、△〖AKX-〗=43.17、△〖AKX-〗=27.88). The difference between the two groups was statistically significant(P<0.05).The overall complication rate in the laparoscopic surgery group (16.67%) was significantly lower than that of the open surgery group (58.33% ). The patients were followed up for 1 year, the overall incidence of complication of laparoscopic surgery group (4.17%) was lower than that of open surgery group (29.17%), the difference was statistically significant(P<0.05).Conclusion：Portal hypertension treated by laparoscopic pericardial devascularization with ALT, AST, TBIL recover faster,less postoperative complications, and better quality a life than pericardial devascularization.  

Key words: laparoscopy, portal hypertension, splenectomy, pericardial devascularization