Objective To investigate the therapeutic outcome of surgical intervention with combined vagus trunk-preserving portoazygous devascularization and shunting (VTPPDS) to treat patients with portal hypertension.Methods The clinical data of portal hypertension patients who underwent VTPPDS (n=28) or portoazygous devascularization in combination with pyloroplasty (PD+PP;n=30) in our hospital from 2005 to 2011 were collected for comparative analysis.The statistical significance of differential rates of gastroenteric function recovery (within 72 hrs post-surgery) , postoperative ventosity and postoperative hemorrhage, status of ascites, and length of hospital stay (discharge within 14 days) were compared between the two groups using the Chi-squared test.Results In the VTPPDS group, 27 patients were cured and one patient died of liver failure.When compared to the PD+PP group, the VTPPDS group showed significantly earlier recovery of gastroenteric function (60.0% vs.85.7%, P<0.05) , lower incidences of postoperative ventosity (43.3% vs.7.1%, P<0.01) and postoperative hemorrhage (26.7% vs.7.1%, P<0.05) , higher incidences of ascites reduction/disappearance (62.5% vs.95.5%, P<0.01) , and shorter length of hospital stay (53.3% vs.78.6%, P<0.05) .Conclusion The VTPPDS procedure is an effective surgical method to treat portal hypertension, and provides superior post-operative outcomes to the PD+PP procedure.