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May 1965

Bleeding Esophageal Varices: Comparison of Operative and Nonoperative Treatment

Author Affiliations

From Washington University School of Medicine, Barnes Hospital, and St. Louis City Hospital. Fellow in Thoracic Surgery (Dr. Satterfield), Professor of Surgery (Dr. Butcher), Washington University; Associate Professor of Clinical Surgery, St. Louis University School of Medicine, and Director of St. Louis City Hospital (Dr. Mulligan).

Arch Surg. 1965;90(5):667-672. doi:10.1001/archsurg.1965.01320110003002

T HIS study is an attempt to evaluate the effectiveness of portal systemic venous anastomosis in preventing death from bleeding esophageal varices, using a group of patients treated without operation as "control" data. The only reports in the literature effectively using such control data are prospective studies1,2 which investigated prophylactic, not therapeutic, operations. This type of data is important because it permits an informed judgment of this widely used operation. In the past such judgment was impossible because the long-term survival of operative series was not always presented clearly, and the only data available on the survival of patients treated without operation were either old or not presented in sufficient detail to permit comparison. McDermott4 and Patton 6 both have recognized these deficiencies.

Material  All the patients in the nonoperative group and some in the operative group were collected by reviewing all records coded as esophageal varices between