Control of bleeding esophageal varices by transabdominal esophageal transection, gastric devascularization, and splenectomy
Weese, J.L.; Starling, J.R.; Yale, C.E.
Surgical Gastroenterology 3(1): 31-36
1984
ISSN/ISBN: 0730-2681 PMID: 6335281 Document Number: 226064
Between November 1980 and October 1982, 11 patients underwent modified Sugiura procedures (esophageal transection, gastric devascularization, and splenectomy) for bleeding esophageal varices, with an operative mortality of 36%. One patient rebled at 2 months and was successfully managed by sclerotherapy. Intraoperative portal pressure fell approximately 25% after splenectomy. We contend that esophageal transection and gastric devascularization provide good short-term control of bleeding varices, and that the decrease in portal pressure provided by splenectomy allows scars to form during a period of reduced portal pressure, providing long-term arrest of variceal hemorrhage.