Azygoportal interruption, fundoplication and vagotomy in hemorrhagic esophageal varices
Rossetti, M.; Allgöwer, D.; Hell, K.
Helvetica Chirurgica Acta 44(4): 481-484
1977
ISSN/ISBN: 0018-0181 PMID: 309462 Document Number: 111695
A vascular interruption to the azygoportal zone, achieved by devascularisation about the cardia and a closed transmural ligation of the varices is described, which is combined with a simultaneous truncal vagotomy, pyloroplasty procedure and a fundoplication. This fourfold method combats the bleeding varices at several points: a direct disruption of vascular paths, haemodynamic control, reduced influence of peptic factors, the management of coincident ulcer pathology and the prevention of gastro-oesophageal reflux. The results from 5 patients are encouraging. This abdominal operation is swift, comparatively atraumatic and may be undertaken in emergency cases and in at-risk patients on an elective basis.