THE SURGICAL TREATMENT OF 71 PATIENTS WITH ESOPHAGEAL VARICES.
The clinical course of 71 patients with esophageal varices who were treated surgically at the Toronto General Hospital in the 17-year period 1947-1964 was reviewed. Forty-five portacaval anastomoses, 19 splenorenal anastomoses and seven transesophageal ligations were performed. The splenorenal shunt was 62% effective and the portacaval shunt 89% effective in preventing further hemorrhage. The end-to-side portacaval shunt was the preferred operation. The overall hospital mortality from a shunting procedure (including emergency procedures) was 17%. The mortality rate was much lower in patients with reasonably normal liver function than in those with elevated serum bilirubin, lowered serum albumin, or refractory ascites. Over 70% of the patients were still alive three years after surgical treatment of the portal hypertension.
D001201:Ascites; D004932:Esophageal and Gastric Varices; D006470:Hemorrhage; D006801:Humans; D006975:Hypertension, Portal; D007565:Jaundice; D008026:Ligation; D008297:Male; D009026:Mortality; D011167:Portacaval Shunt, Surgical; D011172:Portography; D013164:Splenorenal Shunt, Surgical; D013514:Surgical Procedures, Operative
ESOPHAGEAL VARICES; HEMORRHAGE; MORTALITY; PORTACAVAL ANASTOMOSIS; SPLENOPORTOGRAPHY; SURGERY, OPERATIVE