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[Shunt surgery with reference to indications for liver transplantation]
E Broelsch1, P Vogelbach, J C Emond
1Department of Surgery, University of Chicago, Illinois 60637.
Langenbecks Archiv Fur Chirurgie. Supplement II, Verhandlungen Der Deutschen Gesellschaft Fur Chirurgie. Deutsche Gesellschaft Fur Chirurgie. Kongress
|January 1, 1989
Summary
Liver transplantation (OLT) offers a successful treatment for uncontrollable bleeding esophageal varices, demonstrating improved survival rates in transplant candidates with severe liver disease.
Area of Science:
- Hepatology
- Gastroenterology
- Surgical Procedures
Context:
- Bleeding esophageal varices are a serious complication of portal hypertension.
- Established treatments include sclerotherapy and shunt surgery.
- Liver transplantation (OLT) is not widely established as primary therapy for portal hypertension.
Purpose:
- To evaluate the efficacy of OLT in patients with uncontrollable bleeding esophageal varices.
- To compare OLT outcomes with traditional shunt surgery in specific patient groups.
Summary:
- This study analyzed 43 patients with uncontrollable bleeding esophageal varices.
- Fifteen patients underwent urgent or emergency OLT, with 1-year survival rates of 62.5% (5/8 urgent) and 57.1% (4/7 emergency).
- Shunt surgery in non-transplant candidates showed variable survival based on liver disease severity (Child's class A/B: 67-83%; C: 42%).
Impact:
- Results suggest OLT is a viable and successful treatment option for bleeding esophageal varices, particularly in transplant candidates.
- OLT outcomes in active bleeding scenarios indicate its potential to improve survival in severe liver disease patients.
- This study challenges the traditional approach by highlighting OLT's effectiveness in managing this critical condition.