[Long-term results of terminal esophago-proximal gastrectomy for esophageal varices]

Between 1973 and 1991, 193 patients underwent terminal esophagoproximal gastrectomy (TEPG) for esophageal varices. One hundred and sixty patients (84%) were cirrhotics. Ten patients (5.2%) were died within hospital stay. In 116 elective patients who had been free from hepatocellular carcinoma during therapeutic courses, the 5- and 10-year survival rates were 77% and 62% in Child A, and 62% and 38% in Child B, respectively. There was a significant difference between the two groups (p < 0.05). Postoperative rebleeding from esophageal varices was infrequent within 5 years but increased after 5 years especially in Child B and Child C. For patients with these recurrent varices, endoscopic injection sclerotherapy was very effective and improved the prognosis. The survival rate of patients with extremely decreased platelet counts was not different from that of patients without. There were no other severe complications after TEPG. We conclude that TEPG would be indicated firstly for elective or prophylactic cases unless they have severe hepatic damage.