Prophylactic Portal Nondecompression Surgery in Patients with Esophageal Varices

Abstract

This is an interim report of a prospective controlled study to evaluate prophylactic surgery in 112 patients with portal hypertension and esophageal varices treated since 1980. Methods of operation were confined to those with the least influence on portal circulation, namely selective shunts and nonshunting direct interruption procedures. The bleeding rates were 19.2% in the medical group and none in the surgical group (P < 0.01). The mortality in the medical group in case of 1st bleeding was 50%. Operative mortality was 3.3%. There was no difference in the survival rate between the 2 groups at the time of 2 yr follow-up. Prophylactic surgery led to a prevention of esophageal bleeding without any increase in the mortality rates.