Open AccessBleeding Esophageal Varices
Author(s) -
W C Johnson,
D C Nabseth,
Warren C. Widrich,
Harry L. Bush,
Edward T. O’Hara,
AH Robbins
Publication year - 1982
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198204000-00003
Subject(s) - medicine , esophageal varices , varices , gastric varices , embolization , surgery , cirrhosis , percutaneous , sclerotherapy , radiology , portal hypertension
The fate of 359 consecutive alcoholic cirrhotic male patients with bleeding esophageal varices was determined through chart review and personal interview. Three historical periods (1966-70; 1971-75; 1976-80) were defined based on availability of different therapeutic modalities. Management of acutely bleeding varices by conservative, nonsurgical means, including embolization, was preferable to emergency surgery when considering 30-day mortality rates. Percutaneous transhepatic embolization of esophagogastric varices significantly improved the rate of control of hemorrhage and 30-day survival over previously employed nonsurgical methods. The combination of nonsurgical management of acute variceal hemorrhage followed by selective distal splenorenal shunting resulted in maximum salvage of the alcoholic cirrhotic patient.