Esophageal varix bleeding with portal hypertension is one of the major causes of upper G-I bleeding. The appropriate treatment of esophageal varix bleeding is important problems in surgical field. One hundred two cases of esophageal varices with
portal
hypertension had undergone non-shunt surgical operation at Pusan National University Hospital during ten years from January 1984 to December 1993 were reviewed retrospectively.
@ES The results were as follows.
@EN 1) The ratio of male to female was 1.9:1 and the peak age distribution was 5th decade (36.6%).
2) Among 102 paeints, 82 patients had undergone Kobayashi operation. and 20 pateitns had undergone TEPG (Terminal esophago-proximal gastrectomy).
3) Postoperative complications were 20 pulmonary complciations (19.6%), 7 esophageal stricture (6.9%), 5 multiple organ failure (4.9%), 5 wound infection (4.9%). 5 rebleeding (4.9%), 2 hepatic failure (2.0%), 2 subphrenic abscess (2.0%), 2 acute
renal
failure (2.0%).
4) On the postoperative esophagogram, esophageal varices completely disappeared in 57 cases (67.9%), and were partially reduced in 22 cases (26.2%).
5) The overall mortality rate within one month after surgery were 11 cases (10.8%), and the causes of death were multiple organ failure in 4 cases (36.4%), hepatic failure in 2 cases (18.2%), rebleeding in 3 cases (27.3%) pneumonia in 1 case
(9.1%).
Among them, 3 out of 35 in elective cases and 8 out of 52 in emergency cases died.
6) The major factors influencing mortality in non-shunt operations for esophageal varix bleeding were Child classification and timing of operation, and the others were age, hemoglobin value, platelet count, bilirubin value, weight of spleen.
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