Percutaneous transhepatic occlusion for bleeding oesophageal varices

Using the technique described by Lunderquist et al. (1977), transhepatic injection of oesophageal varices has been performed under local anaesthesia in 9 patients with portal hypertension (11 procedures). On 2 occasions it was not possible to enter the left gastric vein. Bleeding resumed within 2 days of radiologically satisfactory occlusion in 2 patients and at 1, 3, 4 and 10 months after 4 procedures in 3 patients. Other complications included portal vein thrombosis, gross ascites and right pleural effusion. There were 2 hospital deaths, both in alcoholic patients with poor hepatic function. In spite of the apparently high morbidity we consider that there is a place for this technique in tiding over patients who are bleeding from oesophageal varices and are medically unsuitable for any surgical procedure.