Clinically significant isolated gastric varices are uncommon, but hemorrhage from gastric varices may be difficult to control with ballon tamponade and Sclerotherapy. In these cases, a direct surgical approach is indicated. Nineteen patients with
gastric variceal hemorrhage were treated surgically during a period of nine years. Procedures for these patients included Hassaboperation (n=12), proximal gastrectomy(n=3), transabdominal esophageal transection (n=1), gastric transection (n=1),
gastrotomic suture ligation (n=1) and portocaval shunt(n=1). In twelve patients (63.2%) emergency operation was necessary. The overall operative mortality was 31.6%, and rebleeding rate of survived patients was 23.1%. In twelve patients who
underwent
Hassab operation, operative mortality and rate of rebleeding was 8.3% and 9.1% respectively, significantly lower than 66.7% and 100.0% in three patients with proximal gastrectomy. One patients who underwent transabdominal esophageal transection
survived
postoperatively. But developed recurrent variceal hemorrhage at two months. Remaining three patients who received other operations died within one month of surgery. Our data showed that Hassab operation offered the best possibilty of prolonged
survival
lower operative mortality.
|