Emergency transhepatic obliteration of bleeding varices

Transhepatic obliteration of gastroesophageal varices was performed in 18 actively bleeding patients. The success of the procedure was related to the complete obliteration of the varices, as demonstrated by their disappearance at angiography. In 13 of the 14 patients in whom obliteration was complete, bleeding did not recur. Three of the 13 died of hepatic insufficiency within 18 days of embolization, and three refused surgery and were lost to follow-up. The remaining seven patients had portacaval or mesocaval shunts, and are doing well at a follow-up of 12 months. Transhepatic obliteration has, therefore, proved to be an effective emergency procedure in patients who will be acceptable surgical candidates at a later date.