Esophageal transection and paraesophagogastric devascularization performed as an emergency measure for uncontrolled...

Thirty patients with portal hypertension underwent as an emergency measure esophageal transection for uncontrolled variceal bleeding. Murphy's anastomotic button and Prioton's clip were used for the transection in 16 patients and the Androsov autosuture stapler gun in the remaining 14 patients. According to the classification of Child, four patients were listed as class A; five, class B, and 21, class C. The survivors have been observed from one to six years. Successful control of the esophageal hemorrhage was achieved in all patients. Immediate operative deaths, within one month, occurred in 17 patients. Five patients had a recurrence of varices. Bleeding recurred in three patients. The over-all survival incidence has been 11 of 30 patients. All survivors are free of hepatic encephalopathy. Transabdominal esophageal mucosal transection with devascularization appears to be satisfactory, but according to our experience, an early recurrence of varices could be expected if the Androsov autosuture stapler gun had been used for the transection.