1994 Volume 55 Issue 11 Pages 2742-2748
In a 26-year period from 1965 to 1991, treatments for esophageal varices have been performed in 26 children. Its long-term clinical results were discussed in this paper. Causes of esophageal varices were congenital extrahepatic portal obstruction (EHPO) in 16, idiopathic portal hypertension in 4, liver cirrhosis or fibrosis in 3, chronic hepatitis in 1, and metabolic liver disease in 2 patients. The total number of treatments came to 45 times.
Operative procedures included transabdominal esophageal or gastric transection with paraeso-phageal devascularization on 16, splenectomy on 10, shunt surgery on 15, and endoscopic injection sclerotherapy on 3 patients. Longterm results after treatments of esophageal varices, shunt surgery groups had lower rehemorrhagic rates than others. It may be a fear that hepatic impairment can occur in a longterm follow up after shunt surgery, but no severe impairment has been seen even 10 to 29 years the operation. We recommend that selective shunt surgery might be the procedure of choice for rehemorrhagic esophageal varices in children as well as adults.
