Abstract
Recently we have performed a new operative procedure (open injection sclerotherapy : splenectomy, devascularization of the greator curverture and posterior side of the upper half of the stomach, ligation and division of the left gastric vessel, and cannulation into the left gastric vein for the postoperarive transcatheter injecton sclerotherapy) for esophago-gastric varices. To evaluate this procedure, we compared open injection scleroherapy (OIS) with transabdominal esophageal transection (TAET). Therapeutic results and postoperative QOL were comparatively evaluated in 15 cases of OIS and 19 cases of TAET. Although disappearance and 1 year recurrence rates were not different significantly between the two groups, 2 year recurrence rate in the OIS group was significantly lower than those in the TAET group (6.7% and 36.8%, respectively). In the TAET group, postoperative complication such as anastomotic leakage or stenosis at the transected portion were observed in 42.5%, on the other hand there were no these complications in the OIS group. Furthermore OIS group had significantly shorter hospital stay than the others (33.5 days and 48.4 days, respectively). Thus, open injection sclerotherapy provides safe and effective treatment of esophago-gastric varices; a combination of devascularization and repeated sclerotherapy through the left gastric vein route.
