Abstract
In the treatment of esophagogastric varices, we investigated a combination therapy of modified Hassab procedure, comprising of circulatory stoppage of the lower esophagus and upper stomach, splenectomy, and pyloroplasty, with postoperative sclerotherapy.
In a recent 5-year period from 1985 to 1989, modified Hassab procedure was performed in 16 cases of esophagogastric varices, of which 14 had liver cirrhosis and 2 had idiopathic portal hypertension as the primary disease. Eleven patients had experienced hematoemesis. Emergency operation was performed in 3 cases; scheduled operation in 8; and prophylactic operation in 5. Modified Hassab procedure alone could yield alleviation or disappearance of the varices in 45.5% of the patients. If the varices were left, postoperative sclerotherapy successfully made the remnant varices disappear. Operation was the enough procedure to treat the gastric varices. There was only one operative death in the emergently operated patient. No rebleeding from varices in a distant site was observed.
For esophagogastric varices, combinative modified Hassab procedure makes the sclerotherapy ease, and it can sufficiently treat gastric varices.
