Kapoor, RAgarwal, SPawar, GVerghese, M1999-10-262009-05-291999-10-262009-05-291999-10-26Kapoor 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): 149-51http://imsear.searo.who.int/handle/123456789/64334BACKGROUND: 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.engEmergency TreatmentEsophageal and Gastric Varices --surgeryFemaleGastrointestinal Hemorrhage --surgeryHumansMaleMiddle AgedRetrospective StudiesJournal Article