Abstract
We studied efficacy of Hassab's operation in 28 cases with solitary gastric varices. Operative death was observed in one case with the Child C liver dysfunction. In remaining all cases varices disappeared irrespective of their location or types of collateral vessels, and no recurrence was observed by endoscopic examination performed one month after the operation. In 2 cases, esophageal varices occurred postoperatively, but their varices were low in degree. No bleeding occurred in either case, although one case was retreated by EIS. Improvement of hypersplenism, hepatic encephalopathy and liver function were observed in some cases. Compared with esophageal varices, development and bleeding of gastric varices are low in frequency. However, once rupture occurs, bleeding is more massive than that in esophageal varices. Therefore, appropriate treatment methods should be selected in consideration of their location and the types of collateral vessels flown into the varices. However, no treatment has yet gained unanimousity regarding safety or reliability for acute bleeding. We propose that Hassab's operation is effective as prophylactic therapy for solitary gastric varices, either residual or newly developed varices seen after EIS, for cases with a high risk of bleeding in near future.
