The results obtained with emergency surgery in the treatment of persistent haemorrhage from gastro-oesophageal varices in the cirrhotic patient

The results of emergency oesophageal transection are described. The overall operative mortality‐rate was 45 per cent. There were no operative deaths in the patients with extrahepatic obstruction and normal liver function. The operative mortality‐rate for the patients with cirrhosis was 53 per cent, or a salvage rate of 47 per cent if one considers that this is a highly selected group of patients (albeit negatively)–patients with impaired liver function who had not responded to intensive medical treatment and who were still bleeding at the time of surgery.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Emergency oesophageal transection in uncontrolled variceal haemorrhage

George

Brown

Ridgway

et al. 1973

“…About half of those patients admitted to hospital die (Rothwell-Jackson and Hunt, 1971;George et al, 1973). The rapid control of massive bleeding constitutes the major initial challenge in the emergency treatment of such patients.…”

mentioning

confidence: 96%

Emergency treatment of variceal haemorrhage

Harrison

Brearley

et al. 1979

For the initial control of haemorrhage from oesophageal varices, two methods of vasopressin administration have been compared--the conventional bolus of 20 units and a low dose infusion of 0.4 units per minute. Twenty patients bleeding from oesophageal varices, confirmed by endoscopy, were allocated into either treatment group (10 in each). Vasopressin infusion stopped bleeding in 86 per cent of the episodes in contrast to 12.5 per cent (P less than 0.01) with bolus doses. Balloon tamponade with a Sengstaken-Blakemore tube was used to control bleeding in only 2 episodes in patients on infusion and in 10 episodes in patients on bolus doses of vasopressin (P less than 0.05). Our study confirms that low dose vasopressin infusion in more effective in controlling bleeding from oesophageal varices than conventional bolus doses.

Long-term results of surgical treatment for bleeding oesophageal varices in children with portal hypertension

Keighley

Girdwood

Wooler

et al. 1973

SUMMARYThe long-term results of surgical treatment for bleeding oesophageal varices in children with portal hypertension are reviewed. Twenty-four children below the age of 13 years who presented with gastrointestinal bleeding over a to-year period form the basis of this study. The importance of the aetiology of portal hypertension on the long-term follow-up has been studied. The results of surgical treatment in controlling haemorrhage are assessed.Though extrahepatic obstruction is considered to be associated with a better long-term prognosis than intrahepatic disease the results of treatment in both groups were similar, with a 7-year survival rate of 75 per cent. Shunt surgery as a definitive procedure is advised in both groups, though the type of shunt used will depend on the age of the child and the site of obstruction.