Esophageal transection by the EEA stapler for bleeding esophageal varices in schistosomal hepatic fibrosis.

Thirty patients with esophageal varices due to schistosomal hepatic fibrosis underwent surgical treatment. They were divided into two groups. The elective group consisted of 20 patients who underwent splenectomy, gastroesophageal devascularization with esophageal transection using the EEA (U.S. Surgical Supply) stapler. The emergency group included ten patients, one of whom had the same procedure as those in the elective group and nine patients who had only esophageal transection with the EEA stapler. The use of the stapler in performing splenectomy and the devascularization operation did not decrease the recurrence of bleeding. Esophageal stapling in the emergency group controlled the bleeding in 90 per cent of the patients. The reappearance of esophageal varices and gastric varices in three patients in the emergency group was managed by distal splenorenal shunt operation.