The acute treatment of haemorrhage from oesophageal varices: A comparison of oesophageal transection and staple gun anastomosis with mesocaval shunt

Publisher Website
Google Scholar
Abstract
Summary: Two matched groups of 20 patients with bleeding oesophageal varices were treated by the same surgical team by either oesophagogastric transection and anastomosis using a mechanical stapling instrument or by mesocaval portosystemic shunt operation. Five of the patients treated by transection died postoperatively, 2 of the survivors developed portosystemic encephalopathy (PSE). 2 died later and 5 rebled. Seven of the patients who had a mesocaval shunt died postoperatively, 8 developed PSE, 3 died later and 4 rebled. It is concluded that oesophagogastric transection and anastomosis using a mechanical instrument is preferable to portal decompression for managing bleeding oesophageal varices in the urgent situation.