Transabdominal oesophageal transection for oesophageal varices: experience in 101 patients

The results of transabdominal oesophageal transection in 101 patients with oesophageal varices are reported. The primary diagnosis was liver cirrhosis and 65 patients, idiopathic portal hypertension in 29 and extrahepatic portal obstruction in 7. Twelve patients died postoperatively. The mortality rate for emergency operations was higher than that for elective and prophylactic procedures. The majority of patients died from hepatic failure. Improvement, judged by radiographic and endoscopic examination, was 100 per cent and 96 per cent, respectively. Post-transection rebleeding was observed in 14 of 89 patients during the follow-up period of 1-13 years. There were 25 late deaths, caused mainly by hepatic failure. The 5-year survival rate, including postoperative deaths, was 72 per cent in idiopathic portal hypertension and 55 per cent in liver cirrhosis. We suggest that transabdominal oesophageal transection is an acceptable operative procedure for oesophageal varices.