[Non-decompression surgery for esophagogastric varices--indication and postoperative result of esophageal transection with paraesophagogastric devascularization and Hassab procedure].
A total of 548 patients had an non-decompression surgery for esophagogastric varices in our hospital, from September 1979 to August 1995. Type of operation includes 402 cases of esophageal transection with paraesophagogastric devascularization (via thoracic approach). 40 cases via abdominal approach, and 106 cases of Hassab procedure. The origin was cirrhosis in 454 patients, IPH in 46, extrahepatic portal occlusion in 29, primary biliary cirrhosis in 6, Budd-Chiari syndrome in 4 and others in 9. Operative mortality rate was less than 1% in child A group, although overall mortality rate including child B, C was 5.0%. By thoracic approach, residual esophageal varices were observed only in 2.5%. Postoperative variceal recurrence were appeared high in cases with hepatocellular carcinoma (HCC). Cumulative recurrence rates at 15 years after surgery were 20.2%, unless HCC had occurred. Cumulative survival rates at 10, 15 years were 52.1%, 45.6% respectively in liver cirrhosis without HCC. Present study confirmed that our operation is effective in controlling esophagogastric varices in long term of periods. Esophagogastric varices of IPH, EHO, and liver cirrhosis of Child A group should be treated by non-decompression surgery.
Beppu
T
T
Second Department of Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Ohashi
K
K
Ohura
S
S
Nakanishi
R
R
Kojima
K
K
Fukasawa
M
M
Futagawa
S
S
D004932:Esophageal and Gastric Varices / Q000401:mortality / Q000601:surgery*; D004947:Esophagus / Q000098:blood supply / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000601:surgery; D006801:Humans; D012008:Recurrence; D013156:Splenectomy; D013270:Stomach / Q000098:blood supply*; D015996:Survival Rate