Gastrointestinal varices surgery: Difference between revisions
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=== Shunting procedures === | === Shunting procedures === | ||
The following shunting procedures may be used for the management of gastrointestinal varices: | |||
'''(a) Pericardial devascularization (PCDV) plus proximal splenorenal shunt (PSRS)''' | '''(a) Pericardial devascularization (PCDV) plus proximal splenorenal shunt (PSRS)''' | ||
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'''(f) Left gastric vena-caval shunt''' | '''(f) Left gastric vena-caval shunt''' | ||
'''(g) Conventional splenorenal shunt''' | |||
=== Non-shunting procedures === | |||
The following non-shunting procedures may be used for managing uncontrolled bleeding from gastrointestinal varices: | |||
'''(a) Ligation of varices and esophageal transection''' | |||
'''(b) Splenic artery ligation''' | |||
'''(c) Esophagogastric devascularization combined with splenectomy''' | |||
'''(d) Splenectomy''' | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 19:34, 5 January 2018
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Gastrointestinal varices Microchapters |
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Differentiating Gastrointestinal varices from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Gastrointestinal varices surgery On the Web |
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American Roentgen Ray Society Images of Gastrointestinal varices surgery |
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Risk calculators and risk factors for Gastrointestinal varices surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Endoscopic procedures along with pharmacotherapy is the first line management of gastrointestinal varices. During endoscopic procedures the rate of hemostasis failure is almost 10%-20%, and mortality is approximately 60% if a second unsuccessful endoscopic treatment is performed without further intervention. In such situation surgical intervention may be required to achieve hemostasis and to stop the bleeding. Surgical shunts used for the management of bleeding gastrointestinal varices include pericardial devascularization plus proximal splenorenal shunt, Warren shunt,
Surgery
- Endoscopic procedures along with pharmacotherapy is the first line management of gastrointestinal varices.
- During endoscopic procedures the rate of hemostasis failure is almost 10%-20%, and mortality is approximately 60% if a second unsuccessful endoscopic treatment is performed without further intervention.
- In such situation surgical intervention may be required to achieve hemostasis and to stop the bleeding.
- The following surgical options are available:[1][2]
Shunting procedures
The following shunting procedures may be used for the management of gastrointestinal varices:
(a) Pericardial devascularization (PCDV) plus proximal splenorenal shunt (PSRS)
(b) A distal splenorenal shunt procedure (DSRS), also called splenorenal shunt procedure and Warren shunt
(c) Interposition shunts (interposing a graft between systemic and splanchnic venous systems)
(d) Caval-mesenteric shunts (direct anastomosis of the divided inferior vena cava to the superior mesenteric vein)
(e) End-to-end portacaval shunts with hepatic arterialization
(f) Left gastric vena-caval shunt
(g) Conventional splenorenal shunt
Non-shunting procedures
The following non-shunting procedures may be used for managing uncontrolled bleeding from gastrointestinal varices:
(a) Ligation of varices and esophageal transection
(b) Splenic artery ligation
(c) Esophagogastric devascularization combined with splenectomy
(d) Splenectomy
References
- ↑ Xu, Chong-En; Zhang, Shu-Guang; Yu, Zhen-Hai; Li, Guang-Xin; Cao, Li-Li; Ruan, Chang-Le; Li, Zhao-Ting (2004). "Combined devascularization and proximal splenorenal shunt: is this a better option than either procedure alone?". Journal of Hepato-Biliary-Pancreatic Surgery. 11 (2): 129–134. doi:10.1007/s00534-003-0881-4. ISSN 0944-1166.
- ↑ Cheema MA, Shehri MY (1995). "Surgery for bleeding esophageal varices". J Pak Med Assoc. 45 (1): 6–9. PMID 7731086.