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Abstract
In the 10 year period from 1964 through 1973, 25 patients bleeding from esophageal
varices underwent ligation procedures coupled with splenectomy rather than a shunt.
These procedures included the transesophageal and transgastric approaches and extragastric
legations. For patients with normal liver function, the risk of this urgent or emergency
surgery is comparatively low (two of 12 patients died). The chance of recurrent hemorrhage
is high (nine of nine surviving patients), as is the need for subsequent surgery (eight
of nine patients). Nevertheless, despite these drawbacks, nine of these 12 patients
(75 percent) are alive, and seven have survived 5 or more years. In patients with
cirrhosis, the initial operative mortality rate (three of 12 patients) and the subsequent
mortality rate (five additional patients) reflect the greater risk because of liver
disease. Only five of 13 patients (38 percent) survive, three of whom are alive 5
or more years after their initial surgery. These results indicate that there are situations
when ligation procedures are valuable, especially in the noncirrhotic patient.
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Article info
Publication history
Accepted:
May 11,
1976
Identification
Copyright
© 1977 Published by Elsevier Inc.
