Between 1975 and 1984, 419 patients with bleeding cent of survivors) and 17 per cent (24 per centof survivors). oesophagogastric varices were subjected to the simplitled The overall survival rates at 1,s and 10 years were 87,76 and operation of highly selective devascularization. All but 57 per cent. Recurrent bleeding was usually controlled by thme were available for follow-up at 5-10 years. The overall endoscopic sclerotherapy and less often by reoperation. mortality rates for urgent and elective operation were 8 and Highly selective devascularization controlled bleeding In 2 per cent respectively. The overall recurrent bleeding rates emergency and elective situations without compromising at 1, 5 and 10 years were 8 per cent, 13 per cent (15 per hepatic function.
Short of liver transplantation, surgery for oesophageal varices must control bleeding without compromising hepatic function or causing undue mortality. Endoscopic sclerotherapy is the major treatment option for this condition. Devascularization may still have a role to play in the surgical management of variceal haemorrhage. The commoner devascularization procedures include portoazygos disconnection1, gastrooesophageal decongestion', paraoesophagogastric devascularizationj and stapling-devas~ularization~. These procedures are extensive and time consuming, sometimes staged, and often necessitate thoracic access and gastric drainage. The present study describes a simplified version of devascularization and reviews the long-term results.