[Indications and results of non-shunting operations for esophageal varices]

Non-shunting operations were performed in 522 patients with esophagogastric varices in our department from January 1964 to March 1989. Transthoracoabdominal esophageal transection was performed in 287 patients (devascularization of the distal esophagus and the proximal half of the stomach and transection of the esophagus). Transthoracic esophageal transection was performed in 125 patients (31 Walker's transection, 94 esophageal transection with devascularization of distal esophagus). Transabdominal esophageal transection was performed in 49 patients. Hassab's operation was performed in 49 patients and three patients were treated with other direct operations (proximal gastrectomy, etc.) Overall mortality of non-shunting operation was 5.0%. The five year survival of idiopathic portal hypertension was 77.6%, extrahepatic portal obstruction was 90.7% and liver cirrhosis was 63.1%. Five year survival of Child's grade A was 79.8%, Child's grade B was 72.9% and Child's grade C was 38.6%. Operation on Child's C patients should be avoided since the results in these patients have been unsatisfactory. Our overall results with esophageal transection over the last two decades are satisfactory.