Abstract
Between January 1971 and December 1986, 51 patients (29 male, 22 female) with esophageal varices underwent surgical intervention.
Twenty-one patients had liver cirrhosis, fourteen had idiopathic portal hypertension and five had extrahepatic portal obstruction.
As for surgical methods, esophageal transection including paraesophagogastric devascularization was applied in 25 patients, proximal gastrectomy in 4, splenectomy alone in 6 and so forth.
Results were assessed comparatively between patients undergoing emergent operation (emergency group) and those recieving elective or prophylactic operation (elective group). The preoperative condition in the emergency group was 9 cases of Child C and 7 of B, while only 1 case out of 35 was judged Child C in the elective group.
Follow-up results were evaluated by the 5-year survival rate: 74.3% in the elective group and 12.5% in the emergency group.
The postoperative course of esophageal varices was observed by means of barium meal and esophagoscopy. After esophageal transection 9 cases were rated as “disappearing”, 9 cases as “improved” and 1 case as “unchanged”. However, after ligation of varices without esophageal transection, or splenectomy alone many cases remained unchanged.
In conclusion, surgical treatment of esophageal varices should involve esophageal transection including paraesophagogastric devascularization. Furthermore, for better results it may be important that emergency operations should be avoided and elective operations should be replaced for these as much as possible.
