LATE RESULTS OF TERMINAL ESOPHAGOPROXIMAL GASTRECTOMY (TEPG) WITH EXTENSIVE DEVASCULARIZATION AND SPLENECTOMY FOR BLEEDING ESOPHAGEAL-VARICES IN CIRRHOSIS

  • 1 January 1976
    • journal article
    • research article
    • Vol. 80  (1) , 106-114
Abstract
The operative procedure of terminal esophagoproximal gastrectomy (TEPG) with extensive esophagogastric devascularization and splenectomy is described in detail, and its rationale is discussed. Late results of this operation performed therapeutically on 64 patients with posthepatitic cirrhosis revealed that the operative mortality rate (death within 1 mo.) was 11%, mostly being contributed by poor-risk patients. The over-all survival was 65% at 5 yr and 59% at 10 yr. Gastrointestinal bleeding recurred in 9 patients, 5 of whom had major and 4 minor hemorrhages. Portasystemic encephalopathy seen frequently after shunts never occurred, and the hepatic encephalopathy was only a sequel of major gastrointestinal bleeding or a manifestation of terminal-stage liver insufficiency. Ascites was not a major clinical problem after this operation; however, mild esophagitis was an occasional complication.

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