Gastrointestinal varices surgery

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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]

(a) Pericardial devascularization (PCDV) plus proximal splenorenal shunt (PSRS)

(b) A distal splenorenal shunt procedure (DSRS), also called splenorenal shunt procedure and Warren shunt

References

  1. 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.