Esophagogastric devascularization and transection for bleeding esophageal varices: first case presentation.
We present the first case of esophagogastric devascularization and esophagogastric transection using a stapler through laparoscopic surgery. The procedure was performed in a 71-year-old diabetic woman with alcoholic liver cirrhosis (Child-Pugh B class), portal hypertension, bleeding grade III esophageal varices, and a previous bleeding episode. The surgical technique was carried out without problems, and the patient had an excellent postoperative condition. Esophagogastric devascularization with esophageal transection using a stapler through laparoscopic surgery is a feasible technique that accomplishes the same and all objectives of the open procedure. Operative time in both methods is the same, whereas surgical trauma, inmunologic depletion, amount of transfused blood, pain, use of analgesics, and hospital stay are reduced in the laparoscopic technique.
Manzano-Trovamala
F J
FJ
Department of General Surgery, Army Central Hospital, Naucalpan, Mexico City, Mexico.
Guttierrez
R L
RL
Marquez
G M
GM
Garcia
R A
RA
Christen
J J
JJ
Guerrero
M G
MG
D000368:Aged; D048909:Diabetes Complications; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000601:surgery*; D004943:Esophagogastric Junction / Q000098:blood supply / Q000601:surgery; D004945:Esophagoscopy; D004947:Esophagus / Q000098:blood supply / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D016558:Hemostasis, Endoscopic; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D013270:Stomach / Q000098:blood supply / Q000601:surgery; D013528:Surgical Staplers