Transabdominal gastroesophageal devascularization without esophageal transection for emergency treatment of variceal hemorrhage.
No Thumbnail Available
Date
1999-10-26
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
BACKGROUND: The Suguira procedure is an effective non-shunting operation to treat life-threatening hemorrhage from esophageal or gastric varices. The goal of esophageal transection is interruption of submucosal varices, but this leads to high morbidity and mortality rates from esophageal fistulization. AIM: To evaluate a variant of this procedure in which the esophagus is not transected, but the varices are underrun from outside the lumen.
METHODS: During the last four and a half years, we performed this modified gastroesophageal devascularization with or without splenectomy in 18 patients as emergency treatment of bleeding esophageal and gastric varices. The data were analyzed retrospectively.
RESULTS: Bleeding was controlled in all patients. Three patients with Child's class C disease undergoing emergency surgery died during the early postoperative period. Rebleeding rate was 17% (3 patients). The overall survival was 72.2% (13 of 18). No patient had encephalopathy over a mean follow up of 30 months.
CONCLUSION: Gastroesophageal devascularization with variceal under-running without esophageal transection is an effective and safe alternative to shunt surgery in the emergency situation.
Description
Keywords
Citation
Kapoor R, Agarwal S, Pawar G, Verghese M. Transabdominal gastroesophageal devascularization without esophageal transection for emergency treatment of variceal hemorrhage. Indian Journal of Gastroenterology. 1999 Oct-Nov; 18(4): 149-51