Introduction: Gastric varices develop in 5–33% of patients with portal hypertension. Gastric variceal bleeding is a major problem accused for a lot of deaths in cirrhotic sufferers, so its management and early prophylaxis is a must. Surgery turns into the only hope for patients with huge varices or resistant cases to repeated endoscopic management. Fundectomy and devascularization may be a good option in this class of patients. The aim of this study is to evaluate endoscopically guided stapled fundal minigasterectomy with periesophagogastric devascularization and splenectomy in treatment of gastric fundal varices. Patients and methods: This study included twenty two selected patients with gastric varices admitted to Gastroenterology, Liver and Laparoscopic unit, General surgery department, Tanta University Hospitals, during the period from January 2014 to January 2016. All cases were operated by endoscopically guided stapled fundal minigasterectomy with periesophagogastric devascularization and splenectomy. The evaluation included operative characteristics, operative findings and morbidity and postoperative complications. Results: The operative time ranged from 75 minutes to 180 minutes, with a mean of 106 + 15 minutes. Intraoperative bleeding occurred in one patient (4.55%) due to injury of one of the retroperitoneal veins treated by underrunning sutures and blood transfusion. There was no operative or postoperative mortality and only one patient developed recurrent fundal varices (4.55%) without bleeding attacks during the follow up period. Follow up ranged from 1 to 2 years with a mean of 1.5 years. Conclusion: Endoscopically guided stapled fundal minigasterectomy with peri-esophagogastric devascularization is a safe and effective method in the treatment and prophylaxis of fundal varices, and should be a used in treating bleeding fundal varices and in prophylaxis of huge ones.
| Published in |
Journal of Surgery (Volume 5, Issue 3-1)
This article belongs to the Special Issue Minimally Invasive and Minimally Access Surgery |
| DOI | 10.11648/j.js.s.2017050301.20 |
| Page(s) | 49-55 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2017. Published by Science Publishing Group |
Fundal Minigastrectomy, Gastric Varices, Fundal, Devascularization, Peri-esophagogastric
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APA Style
Taha Ahmed Esmail, Sherief Abd-Elsalam. (2017). The Efficacy and Safety of Endoscopically Guided Stapled Fundal Mini-Gastrectomy for the Treatment of Bleeding Fundal Varices: A Single Tertiary Care Center Experience. Journal of Surgery, 5(3-1), 49-55. https://doi.org/10.11648/j.js.s.2017050301.20
ACS Style
Taha Ahmed Esmail; Sherief Abd-Elsalam. The Efficacy and Safety of Endoscopically Guided Stapled Fundal Mini-Gastrectomy for the Treatment of Bleeding Fundal Varices: A Single Tertiary Care Center Experience. J. Surg. 2017, 5(3-1), 49-55. doi: 10.11648/j.js.s.2017050301.20
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Download@article{10.11648/j.js.s.2017050301.20,
author = {Taha Ahmed Esmail and Sherief Abd-Elsalam},
title = {The Efficacy and Safety of Endoscopically Guided Stapled Fundal Mini-Gastrectomy for the Treatment of Bleeding Fundal Varices: A Single Tertiary Care Center Experience},
journal = {Journal of Surgery},
volume = {5},
number = {3-1},
pages = {49-55},
doi = {10.11648/j.js.s.2017050301.20},
url = {https://doi.org/10.11648/j.js.s.2017050301.20},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.s.2017050301.20},
abstract = {Introduction: Gastric varices develop in 5–33% of patients with portal hypertension. Gastric variceal bleeding is a major problem accused for a lot of deaths in cirrhotic sufferers, so its management and early prophylaxis is a must. Surgery turns into the only hope for patients with huge varices or resistant cases to repeated endoscopic management. Fundectomy and devascularization may be a good option in this class of patients. The aim of this study is to evaluate endoscopically guided stapled fundal minigasterectomy with periesophagogastric devascularization and splenectomy in treatment of gastric fundal varices. Patients and methods: This study included twenty two selected patients with gastric varices admitted to Gastroenterology, Liver and Laparoscopic unit, General surgery department, Tanta University Hospitals, during the period from January 2014 to January 2016. All cases were operated by endoscopically guided stapled fundal minigasterectomy with periesophagogastric devascularization and splenectomy. The evaluation included operative characteristics, operative findings and morbidity and postoperative complications. Results: The operative time ranged from 75 minutes to 180 minutes, with a mean of 106 + 15 minutes. Intraoperative bleeding occurred in one patient (4.55%) due to injury of one of the retroperitoneal veins treated by underrunning sutures and blood transfusion. There was no operative or postoperative mortality and only one patient developed recurrent fundal varices (4.55%) without bleeding attacks during the follow up period. Follow up ranged from 1 to 2 years with a mean of 1.5 years. Conclusion: Endoscopically guided stapled fundal minigasterectomy with peri-esophagogastric devascularization is a safe and effective method in the treatment and prophylaxis of fundal varices, and should be a used in treating bleeding fundal varices and in prophylaxis of huge ones.},
year = {2017}
}
TY - JOUR T1 - The Efficacy and Safety of Endoscopically Guided Stapled Fundal Mini-Gastrectomy for the Treatment of Bleeding Fundal Varices: A Single Tertiary Care Center Experience AU - Taha Ahmed Esmail AU - Sherief Abd-Elsalam Y1 - 2017/03/06 PY - 2017 N1 - https://doi.org/10.11648/j.js.s.2017050301.20 DO - 10.11648/j.js.s.2017050301.20 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 49 EP - 55 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.s.2017050301.20 AB - Introduction: Gastric varices develop in 5–33% of patients with portal hypertension. Gastric variceal bleeding is a major problem accused for a lot of deaths in cirrhotic sufferers, so its management and early prophylaxis is a must. Surgery turns into the only hope for patients with huge varices or resistant cases to repeated endoscopic management. Fundectomy and devascularization may be a good option in this class of patients. The aim of this study is to evaluate endoscopically guided stapled fundal minigasterectomy with periesophagogastric devascularization and splenectomy in treatment of gastric fundal varices. Patients and methods: This study included twenty two selected patients with gastric varices admitted to Gastroenterology, Liver and Laparoscopic unit, General surgery department, Tanta University Hospitals, during the period from January 2014 to January 2016. All cases were operated by endoscopically guided stapled fundal minigasterectomy with periesophagogastric devascularization and splenectomy. The evaluation included operative characteristics, operative findings and morbidity and postoperative complications. Results: The operative time ranged from 75 minutes to 180 minutes, with a mean of 106 + 15 minutes. Intraoperative bleeding occurred in one patient (4.55%) due to injury of one of the retroperitoneal veins treated by underrunning sutures and blood transfusion. There was no operative or postoperative mortality and only one patient developed recurrent fundal varices (4.55%) without bleeding attacks during the follow up period. Follow up ranged from 1 to 2 years with a mean of 1.5 years. Conclusion: Endoscopically guided stapled fundal minigasterectomy with peri-esophagogastric devascularization is a safe and effective method in the treatment and prophylaxis of fundal varices, and should be a used in treating bleeding fundal varices and in prophylaxis of huge ones. VL - 5 IS - 3-1 ER -
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