BACKGROUND: The optimum procedure for long-term management of oesophagogastric varices when endoscopic sclerotherapy or ligation fails is yet to be established. This report describes a new procedure for treating huge oesophagogastric varices by open injection sclerotherapy. METHODS: Twenty-three patients with huge oesophagogastric varices underwent laparotomy and devascularization of the upper stomach with splenectomy. The left gastric vein was catheterized for repeated injection of 5 per cent ethanolamine oleate during the postoperative period. RESULTS: In all patients, the varices were eradicated after a mean of 3 sessions of sclerotherapy. There were no deaths or major complications during the mean follow-up period of 41 months. Small recurring varices in two patients were treated successfully by endoscopic sclerotherapy and interventional radiology. CONCLUSION: Open injection sclerotherapy is an effective and safe procedure for the treatment of huge oesophagogastric varices.
BACKGROUND: The optimum procedure for long-term management of oesophagogastric varices when endoscopic sclerotherapy or ligation fails is yet to be established. This report describes a new procedure for treating huge oesophagogastric varices by open injection sclerotherapy. METHODS: Twenty-three patients with huge oesophagogastric varices underwent laparotomy and devascularization of the upper stomach with splenectomy. The left gastric vein was catheterized for repeated injection of 5 per cent ethanolamine oleate during the postoperative period. RESULTS: In all patients, the varices were eradicated after a mean of 3 sessions of sclerotherapy. There were no deaths or major complications during the mean follow-up period of 41 months. Small recurring varices in two patients were treated successfully by endoscopic sclerotherapy and interventional radiology. CONCLUSION: Open injection sclerotherapy is an effective and safe procedure for the treatment of huge oesophagogastric varices.