Esophagogastric devascularization and transection for bleeding esophageal varices: first case presentation

Area of Science:

• Gastroenterology
• Surgical Innovation
• Minimally Invasive Surgery

Background:

• Esophageal varices are a serious complication of portal hypertension, often requiring surgical intervention.
• Previous surgical treatments for bleeding esophageal varices, such as esophagogastric devascularization and transection, were typically performed via open laparotomy.
• Alcoholic liver cirrhosis with portal hypertension presents significant surgical challenges.

Observation:

• A novel laparoscopic approach for esophagogastric devascularization and stapler-assisted esophagogastric transection was successfully performed.
• The procedure was applied to a patient with alcoholic liver cirrhosis (Child-Pugh B), portal hypertension, and grade III esophageal varices with a history of bleeding.
• The surgery was completed without complications, and the patient demonstrated an excellent postoperative recovery.

Findings:

• Laparoscopic esophagogastric devascularization and transection effectively achieves the objectives of open procedures.
• Key benefits of the laparoscopic technique include reduced surgical trauma, less immunologic depletion, decreased blood transfusion requirements, and lower pain scores.
• Hospital stay duration was also notably reduced in the laparoscopic group compared to open surgery.

Implications:

• This laparoscopic technique presents a viable and potentially superior alternative to open surgery for managing complex esophageal varices.
• The findings suggest that minimally invasive surgery can offer comparable efficacy with improved patient outcomes.
• Further research and broader adoption of this technique could enhance patient care and reduce healthcare resource utilization.