ARE DEVASCULARIZATION AND TRANSSECTION INDICATED IN THE TREATMENT OF BLEEDING ESOPHAGEAL-VARICES

Abstract

Sugiura procedure and its modfications were performed in 43 patients who were not suitable for shunt surgery. Four types of devascularisation-transection procedures on the technical basis of Sugiura operation were carried out. Thirteen patients died in the early postoperative period. Highest mortality was recorded in the standard Sugiura procedure (4/8 or 50%) and the lowest in modified Sugiura III (1/7 or 14 %) which is the simpliest form of all. Mortality in the early postoperative period was higher in emergency procedures. No variceal hemorrhage and hepatic encephalopathy were recorded in the early postoperative period. Based on our experience in relatively limited number of cases, the Sugiura operation and its modifications are not adventageous in emergency conditions and patients with poor liver function. However, these procedures can be performed in Child A-B cases. Limiting the extent of the operation by modifications affects the outcome positively.