Results of nonshunting operation and injection sclerotherapy for esophageal varices.
The results of a total of 523 nonshunting operations performed at our institution from 1964 to 1990 were analyzed and compared to those of chronic sclerotherapy. Although the overall operative mortality rate of nonshunting operations was low (26/523:5.0%), it was relatively high in Child's C cirrhotic patients (22/129:17%) and in those who underwent surgery on an emergency basis (14/60:23%). Cumulative survival rates of Child's C cirrhotic patients at 5 and 10 years (37.4%, 13.0%) following nonshunting operations were much lower than those of Child's A (76.6%, 54.9%) or Child's B (71.6%, 35.5%). One- and three-year survival rates for patients treated with sclerotherapy were 90%, 72% in Child's A (22 patients), 82%, 49% in Child's B (47), and 56%, 30% in Child's C (50), while cumulative rebleeding rates at one and three years following sclerotherapy were 12%, 12% in Child's A, 18%, 27% in Child's B, and 35%, 55% in Child's C respectively. Our data indicated that nonshunting operations can be safely performed with a good long-term outcome in Child's A or B cases on an elective basis, and sclerotherapy may be the treatment of choice for emergency cases or for Child's C cases although the risk of rebleeding is high following sclerotherapy.
Kawasaki
S
S
Second Department of Surgery, Faculty of Medicine, University of Tokyo, Japan.
Sanjo
K
K
Idezuki
Y
Y
D004932:Esophageal and Gastric Varices / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D006801:Humans; D015911:Sclerotherapy; D015996:Survival Rate; D013997:Time Factors