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Selection of operation in patients with bleeding esophageal varices.
Can Med Assoc J. 1978 Feb 18; 118(4):369-72.CM

Abstract

The results of surgical treatment of bleeding esophageal varices over an 8-year period in 155 patients are reviewed. Primary treatment of bleeding was conservative, with intravenous administration of vasopressin and balloon tamponade. Emergency operations were carried out after 48 hours in persons with persistent bleeding who were surgical candidates. Operative mortality was higher in this group (40%) than in those undergoing elective or urgent operations (each 10%). Postoperative encephalopathy occurred in 35% of patients and was correlated closely to late death after establishment of a shunt. The mesocaval shunt is no better than the portacaval but appears to be a good alternative in an emergency. In a controlled trial the distal splenorenal shunt was found to be associated with a lower rate of postoperative encephalopathy than the portacaval shunt, but thus far the long-term survival rates have not differed.

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Authors

Langer B
No affiliation info available
Patel SC
No affiliation info available
Stone RM
No affiliation info available
Colapinto RF
No affiliation info available
Phillips MJ
No affiliation info available
Fisher MM
No affiliation info available

MeSH

Blood Vessel ProsthesisBrain DiseasesEsophageal and Gastric VaricesFollow-Up StudiesGastrointestinal HemorrhageHumansMesenteric VeinsPortacaval Shunt, SurgicalPostoperative ComplicationsRenal VeinsSplenic VeinTime FactorsVena Cava, Inferior

Pub Type(s)

Journal Article

Language

eng

PubMed ID

305280

Citation

Langer, B, et al. "Selection of Operation in Patients With Bleeding Esophageal Varices." Canadian Medical Association Journal, vol. 118, no. 4, 1978, pp. 369-72.
Langer B, Patel SC, Stone RM, et al. Selection of operation in patients with bleeding esophageal varices. Can Med Assoc J. 1978;118(4):369-72.
Langer, B., Patel, S. C., Stone, R. M., Colapinto, R. F., Phillips, M. J., & Fisher, M. M. (1978). Selection of operation in patients with bleeding esophageal varices. Canadian Medical Association Journal, 118(4), 369-72.
Langer B, et al. Selection of Operation in Patients With Bleeding Esophageal Varices. Can Med Assoc J. 1978 Feb 18;118(4):369-72. PubMed PMID: 305280.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Selection of operation in patients with bleeding esophageal varices. AU - Langer,B, AU - Patel,S C, AU - Stone,R M, AU - Colapinto,R F, AU - Phillips,M J, AU - Fisher,M M, PY - 1978/2/18/pubmed PY - 1978/2/18/medline PY - 1978/2/18/entrez SP - 369 EP - 72 JF - Canadian Medical Association journal JO - Can Med Assoc J VL - 118 IS - 4 N2 - The results of surgical treatment of bleeding esophageal varices over an 8-year period in 155 patients are reviewed. Primary treatment of bleeding was conservative, with intravenous administration of vasopressin and balloon tamponade. Emergency operations were carried out after 48 hours in persons with persistent bleeding who were surgical candidates. Operative mortality was higher in this group (40%) than in those undergoing elective or urgent operations (each 10%). Postoperative encephalopathy occurred in 35% of patients and was correlated closely to late death after establishment of a shunt. The mesocaval shunt is no better than the portacaval but appears to be a good alternative in an emergency. In a controlled trial the distal splenorenal shunt was found to be associated with a lower rate of postoperative encephalopathy than the portacaval shunt, but thus far the long-term survival rates have not differed. SN - 0008-4409 UR - https://www.unboundmedicine.com/medline/citation/305280/Selection_of_operation_in_patients_with_bleeding_esophageal_varices_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/305280/ DB - PRIME DP - Unbound Medicine ER -