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April 1956

Treatment of Bleeding Esophageal Varices by Resection of the Lower Esophagus: Reestablishment of Esophagogastric Continuity by Means of a Polyethylene Tube

Author Affiliations

From the First (Tufts) Surgical Service, the Boston City Hospital.; Present address, the Sinai Hospital of Baltimore, and the Johns Hopkins University School of Medicine.

AMA Arch Surg. 1956;72(4):634-643. doi:10.1001/archsurg.1956.01270220082011

INTRODUCTION  Although many operations have been devised for the treatment of bleeding esophageal varices secondary to cirrhosis of the liver, at present only three procedures are in fairly common usage. These are (1) the shunting of portal blood to the caval system, (2) the transesophageal ligation of the varices, and (3). the resection of the cardio-esophageal region with esophagogastrostomy.The advocates of the shunt operations emphasize the importance of lowering the portal hypertension, which is believed to be responsible for the development of the varices.* This may be accomplished by a satisfactory anastomosis between the portal or splenic veins and the inferior vena cava or left renal vein. Evidence of the reduction of portal pressure has been obtained at the operating table by measuring the portal pressure before and after the shunt has been performed † and also in the postoperative period by measuring the pressure in the varix through