Comparison of Clinical Findings and Surgical Results between Gastric and Esophageal Varices

Yuichiro Ogawa, Hirofumi Yukaya, Yukiharu Sasaki, Akira Nagashima, Atsushi Fukuda, Yosuke Adachi, Takafumi Hayashi

Department of Surgery, Hiroshima Red Cross&Atomi-bomb Survivors Hospital

One hundred ninety-two cases of esophagogastric varices treated surgically during the past 20 years in our surgical department were divided into the following three groups: group I (esophageal varices alone) 111 cases; group II (esophageal and gastric varices) 72 cases and group III (gastric varices alone) 9 cases. The clinical findings and operative results in the three groups were compared. No significant difference was found in age, sex ratio, underlying liver disease and grade of liver dysfunction among the three groups. Of the angiographic collateral venous patterns, the left gastric venous dominant type was the most frequent pattern in group I and group II while it was the least frequent pattern in group III. Portal venous pressure was significantly low in group III (p<0.01). The grade of gastric varices was significantly more severe in group III than in group II (p<0.01), and the main location of gastric varices was the cardia in group II while it was the fundus in group III. The incidence of variceal hemorrhage was highest in group II, but an emergency operation was necessary most often in group III. Gastric varices were more frequently reduced (86.8%) than esophageal varices (74.2%) by any operative procedure (p<0.05).

Key words
gastric varices, esophageal varices, portal hypertension, surgical treatment of esophagogastric varices

Reprint requests
Yuichiro Ogawa Department of Surgery, Hiroshima Red Cross&Atomic-bomb Survivors Hospital
1-9-6 Sendamachi Naka-ku, Hiroshima, 730 JAPAN

Accepted
February 13, 1991

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