Esophageal varix bleeding by portal hypertension is one of the three major causes of upper G-I bleeding, and it's appropriate treatment are great problems for every surgeon.
Transient hemostasis of esophageal varix bleeding is not a adequate treatment for portal hypertension, because there are many fundamental background disease.
But, massive bleeding for varix is a major cause of death, so emergent bleeding control is essential for salvage.
The mode of treatments of esophageal varix bleeding are very similar in many contries except in favorite surgical procedures between the orient and western countries.
We want to introduce the 686 cases of esophageal varix bleeding which had been treated surgically in Korea from 1960 to 1989 years, and also 237 cases which had been treated by Endoscopic Injection Sclerotherapy at the Korea university hospital
from
1980 to 1989.
1) The ratio between the postnecrotic and alcoholic cirrhosis was 7.9 : 1 as a etiology of portal hypertension which had been treated surgically during last 30 years.
2) Among the treatment of esophageal varix bleeding, emergency operation was performed at 23.9% but EIS was done urgently at 56.5%.
3) Of the operated group of patients, the Child C category was 23.9%, but it was 41.4% for the EIS group of patients.
4) Over the last three decades, the trend of the surgical procedural preference was portasystemic shunt(98.9%) In 1960's reduced to 64.8% in 1970's but the ablative procedure was mostly preferred(61.5%).
5) The success rate of EIS which accounts for the number of patients in admission which completely controlled bleeding with the procedures was 85.2% and it's success rate in the Child C group was 73.5%.
In should be pointed out that the rebleeding rate for EIS in the first three months was 49.1%.
As a review of the above results, the preferential surgical procedures of esophageal varix bleeding in Korea was ablative procedures.
EIS was performed essentially as a urgent and initial bleeding control method, and it was also more recommended than surgical procedures for treatment of the Child C group patients. But, more improvement and investigation is demmanded for
complete
eradication of varix and prevention of rebleeding.
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