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  • Title: Bleeding esophageal varices: treatment with vasopressin, transhepatic embolization and selective splenorenal shunting.
    Author: Johnson WC, Nabseth DC, Widrich WC, Bush HL, O'Hara ET, Robbins AH.
    Journal: Ann Surg; 1982 Apr; 195(4):393-400. PubMed ID: 6978109.
    Abstract:
    The fate of 359 consecutive alcoholic cirrhotic male patients with bleeding esophageal varices was determined through chart review and personal interview. Three historical periods (1966-70; 1971-75; 1976-80) were defined based on availability of different therapeutic modalities. Management of acutely bleeding varices by conservative, nonsurgical means, including embolization, was preferable to emergency surgery when considering 30-day mortality rates. Percutaneous transhepatic embolization of esophagogastric varices significantly improved the rate of control of hemorrhage and 30-day survival over previously employed nonsurgical methods. The combination of nonsurgical management of acute variceal hemorrhage followed by selective distal splenorenal shunting resulted in maximum salvage of the alcoholic cirrhotic patient.
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