This study included thirty patients presented with recurrent bleeding
from oesophago-gastric varices, they were resuscitated, diagnosed by fibre-
optic endoscopy and subjected to full clinical and laboratory investigations
and were classified according to Child-Paugh classification as 18
patients class (A) (60%) and 12 patients as class (B), (40%) they underwent
splenectomy vasoligation, direct gastric variceal ligation and oesophageal
transection using LEA stapler, patients were followed up 1
year for further bleeding and endoscopically to show the fate of varices.
Complete eradication of varices was noted in 13 patients (46.4%) and
the grade of varices greatly diminished in the others. The mortality rate
was 2 patients 6.6%. complications were minors and mostly transitory.
included transient dysphagia in 4 patients (13.3 96) and persistant dysphagia
in one (3.3%). pulmonary complications in 4 patients. (13.3%), gastric
stasis in one (3.3%) and heart burn in 6 patients. (21.4%). Late complications
(in suruived 28 patients) included ascites in 5 (17.8%) patients.
Encephalopathy in one (3.57%) and incisional hernia in two patients
(7.14%) .
It is concluded that oesophageal transection and isplenectomy vasoligation
with direct ligation of fundic varices in treatment of recurrent Meeing
oesophagogastric varices, is simple, effective method for variceal
eradication and control of bleeding. |
