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Donald W. S. Yim, MD; Akio Wakabayashi, MD; Junichi Hirai, MD; Nisha D. Mukherjee, MD; John E. Connolly, MD

AMA Arch Surg. 1970;100(4):367-371.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In spite of ideal present day management, 25% of patients who bleed from esophageal varices continue to succumb to hemorrhage. Those who fail to respond to conservative measures require surgical intervention. Major surgery on a patient already taxed by exsanguinating hemorrhage and hepatic decompensation is accompanied by a high mortality.

White et al,¹ Piccone and LeVeen,² and Christopherson et al³ have recently described the use of an umbilical systemic vein shunt with low operative mortality to control bleeding from esophageal varices. Their reports indicate that flows obtained under existing portosystemic pressure differentials were sufficient to abate exsanguination.

Gott et al⁴ have described a non thrombogenic coating technique for surfaces using graphite, heparin sodium, and benzalkonium chloride. Zarins et al⁵ have recently reported their results with splenofemoral or external jugular shunts to relieve portal hypertension in dogs utilizing the Gott graphite-benzalkonium-heparin coating. We⁶ have developed . . . [Full Text PDF of this Article]

Author Affiliations
Irvine, Calif

From the Department of Surgery, University of California, Irvine.

Footnotes
Accepted for publication Dec 10, 1969.

Read before the 77th annual meeting of the Western Surgical Association, Dallas, Nov 21, 1969.

Reprint requests to Department of Surgery, University of California, Irvine, Calif 92668 (Dr. Connolly).

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