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An attempt has been made to reduce the immediate mortality rate from bleeding esophageal varices by performing an emergency transesophageal suturing of the bleeding vessels at the time of acute hemorrhage. This procedure has been performed in eleven patients during the past two years with one immediate postoperative death, or an operative mortality of 9 per cent. It is recommended especially for the patient with cirrhosis of the liver with uncontrollable bleeding in whom balloon tamponade is necessary to stop the bleeding, since not infrequently bleeding starts again after removal of the balloon. Immediate or early suturing of the ruptured esophageal varix is considered a lifesaving procedure in these cases and it permits, in addition, adequate time to prepare the patients, many of whom are critically ill, for the major surgical procedure of constructing some type of portacaval shunt. This two-stage operative method has been accomplished successfully in six patients with bleeding esophageal varices secondary to cirrhosis of the liver.
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White, B.: Personal communication.
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☆Read at the sixth annual meeting of the Society for Vascular Surgery, Chicago, Ill, June 8, 1952.
© 1953 Published by Elsevier Inc.