 |
|
Transthoracoesophageal Ligation of Bleeding Esophageal VaricesA Reappraisal
LeRoy S. Wirthlin, MD;
Robert R. Linton, MD;
Daniel S. Ellis, MD
AMA Arch Surg. 1974;109(5):688-692.
Abstract
| |
Transthoracoesophageal ligation of bleeding esophageal varices was carried out in 55 patients with a survival of 71%. All good-risk patients (Child criteria) survived; 75% of moderate-risk patients and 48% of poor-risk patients survived. Nine patients underwent exploratory surgery for recurrent variceal bleeding following a portosystemic shunt, and 46 patients underwent variceal ligation as the first step of a two-stage procedure for the control of bleeding esophageal varices. Sixty-four percent of the latter group had a subsequent portosystemic shunt, usually of the splenorenal type, to avoid encephalopathy and liver failure associated with portacaval shunt. Group A and B patients had 52% cumulative survival at five years and 24% cumulative survival at ten years. Transthoracoesophageal ligation of varices, followed preferably by an end-to-side splenorenal shunt and splenectomy, remains the most satisfactory method for the control of esophageal bleeding secondary to Laënnec cirrhosis.
Author Affiliations
From the departments of surgery (Drs. Wirthlin and Linton) and medicine (Dr. Ellis), Massachusetts General Hospital and the Harvard Medical School, Boston.
Footnotes
Accepted for publication July 16, 1974.
Read before the 22nd scientific meeting of the International Cardiovascular Society, Chicago, June 22, 1974.
Reprint requests to 1180 Beacon St, Brookline, MA 02146 (Dr. Wirthlin).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
The History of the Surgical Treatment of Portal Hypertension
Chandler
Arch Surg 1993;128:925-940.
ABSTRACT
Mortality and Rebleeding After Hypertensive Variceal Disconnections
VanBeek et al.
Arch Surg 1984;119:446-449.
ABSTRACT
|
