 |
|
Portasystemic Shunting Remains the Procedure of Choice for Control of Variceal Hemorrhage
Barry A. Levine, MD;
Harold V. Gaskill, III, MD;
Kenneth R. Sirinek, MD, PhD
Arch Surg. 1985;120(3):296-300.
Abstract
• We reviewed 108 patients (50% Child's C) who had been admitted with acutely bleeding esophageal varices to compare the efficacy of operative (portasystemic shunt) therapy with the reported efficacy of sclerotherapy. In the patients with shunts the early mortality (preoperative plus operative) was 13% and late mortality was 23%. Survival at five years was 50%. Recurrent variceal bleeding was seen in 4% of the patients. Procedure-related mortality and variceal rebleeding rates for the shunt group were respectively 50% and 8% of that reported for sclerotherapy. Variceal rebleeding in the sclerotherapy group required approximately 7 units of blood per episode. We concluded that immediate attempts at control of hemorrhage followed by portasystemic shunting remains the therapy of choice for these patients.
(Arch Surg 1985;120:296-300)
Author Affiliations
From the Departments of Surgery, Audie L. Murphy Memorial Veterans Hospital, and The University of Texas Health Science Center, San Antonio, Tex.
Footnotes
Accepted for publication Oct 23, 1984.
Read before the Eighth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Los Angeles, May 10, 1984.
Reprint requests to Department of Surgery, The University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78284 (Dr Levine).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Improving Survival in Patients With Cirrhosis Undergoing Major Abdominal Operations
Sirinek et al.
Arch Surg 1987;122:271-273.
ABSTRACT
|
