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Transvenous sclerotherapy for huge oesophagogastric varices using open injection sclerotherapy
1Department of Surgery I, Oita Medical University, Oita 879-5593, Japan.
Background:
The optimum procedure for long-term management of oesophagogastric varices when endoscopic sclerotherapy or ligation fails is yet to be established. This report describes a new procedure for treating huge oesophagogastric varices by open injection sclerotherapy.
Methods:
Twenty-three patients with huge oesophagogastric varices underwent laparotomy and devascularization of the upper stomach with splenectomy. The left gastric vein was catheterized for repeated injection of 5 per cent ethanolamine oleate during the postoperative period.
Results:
In all patients, the varices were eradicated after a mean of 3 sessions of sclerotherapy. There were no deaths or major complications during the mean follow-up period of 41 months. Small recurring varices in two patients were treated successfully by endoscopic sclerotherapy and interventional radiology.
Conclusion:
Open injection sclerotherapy is an effective and safe procedure for the treatment of huge oesophagogastric varices.