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Gastric devascularization and splenectomy for bleeding gastric varices
J Kollias1, P L Jeans, R T Padbury
1Department of Surgery, Flinders Medical Centre, Flinders University of South Australia, Bedford Park, Adelaide, Australia.
The Australian and New Zealand Journal of Surgery
|November 1, 1995
Summary
Gastric devascularization effectively controlled life-threatening bleeding from gastric varices in a small patient group when other methods failed. This surgical approach offers effective palliation for patients with portal hypertension and bleeding gastric varices.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Hepatology
Background:
- Gastric varices, often linked with esophageal varices in portal hypertension, present significant hemorrhage control challenges.
- Non-operative measures frequently fail to manage life-threatening bleeding from gastric varices.
Purpose of the Study:
- To evaluate the efficacy of gastric devascularization in controlling severe hemorrhage from gastric varices.
- To assess the long-term outcomes and safety of this surgical intervention.
Main Methods:
- Six patients with bleeding gastric varices underwent gastric devascularization between June 1988 and February 1990.
- Patients had failed non-operative treatments prior to surgery.
- Outcomes including hemorrhage control, mortality, complications, and variceal eradication were monitored.
Main Results:
- Gastric devascularization successfully controlled hemorrhage in all six patients.
- One peri-operative death occurred due to hepatic failure.
- Four patients experienced manageable postoperative infections; five survivors achieved variceal eradication after a mean 44-month follow-up.
Conclusions:
- Gastric devascularization is an effective surgical option for controlling life-threatening hemorrhage from gastric varices.
- The procedure provides good palliation for patients with portal hypertension and bleeding gastric varices.
- Despite risks, surgical intervention offers a viable solution when conservative treatments are insufficient.