Analyses of portal hypertensive collateralis by endoscopic ultrasonography: With a classification of esophagogastric varices

Hand‐assisted Laparoscopic Splenectomy and Devascularization of the Upper Stomach in the Management of Gastric Varices

“…One disadvantage of the Hassab operation is that esophageal varices may occur because the Hassab procedure cannot block venous blood flow in the esophageal wall. However, in a recent study, this disadvantage was minimized by combining the Hassab operation with endoscopic sclerotherapy which has had satisfactory results 31,32. A significant merit of the Hassab operation compared with other interventions is that when combined with splenectomy, the development of thrombocytopenia can be avoided.…”

“…However, in a recent study, this disadvantage was minimized by combining the Hassab operation with endoscopic sclerotherapy which has had satisfactory results. 31,32 A significant merit of the Hassab operation compared with other interventions is that when combined with splenectomy, the development of thrombocytopenia can be avoided. It is known that after splenectomy, there is an elevation of platelet count.…”

Long‐Term Results of Fundectomy and Periesophagogastric Devascularization in Patients with Gastric Fundal Variceal Bleeding

“…We subsequently abandoned the transaction procedure to avoid the risk of anastomotic leakage. Devascularization of periesophagogastric vessels, as reported by Hassab and associates, is also widely used to treat gastric variceal bleeding [4,15,16]. However, we found that gastric varices remain visible in the intramural area after this technique, and that raised a concern that they might cause recurrent gastric variceal bleeding.…”

New Operative Method for Fundal Variceal Bleeding: Fundectomy with Periesophagogastric Devascularization

“…A splenectomy was the initial procedure, although it was omitted in the first 4 cases; it was performed in the remaining 19 cases. Next, the periesophageal and perigastric vessels were devascularized, as described by Hassab and colleagues [6, 7]. The retroperitoneal vessels were preserved as much as possible so as not to disrupt the portosystemic circulation.…”

“…The retroperitoneal vessels were preserved as much as possible so as not to disrupt the portosystemic circulation. In addition, the left gastric vein and artery were ligated at their roots [6]. The extent of devascularization included the lower 5 cm of the esophagus, the lesser curvature to the level of the incisura angularis, and the greater curvature of the stomach to the level adjacent to the incisura angularis [7].…”