Clinical Study on Surgical Treatment of 19 Cases of Solitary Gastric Varices

Kaoru Ohashi, Gotaro Orihata, Hiroshi Kanada, Shinsuke Ohura, Kuniaki Kojima, Masaki Fukazawa, Tomoe Beppu, Shunji Futagawa

The Second Department of Surgery, School of Medicine, Juntendo University

The clinical features and surgical results were studied in 19 cases of solitary gastric varices. Blood supply to the gastric varices was classified into the following three groups: Group I (left gastric vein dominant type), two cases; Group II (left and posterior, short gastric vein equivalent type), six cases; and Group III (posterior, short gastric vein dominant type), eleven cases. Gastrorenal shunt was found in 18 of the 19 cases. The Groups I and II showed significantly higher NH₃ levels in peripheral blood than Group III (p<0.05). In groups I and II, the serum NH₃ level in the inferior vena cava showed significant elevation above the influx of the renal vein (p<0.05); however, in Group III the caval NH₃ level was almost the same above and below of the renal vein. Devascularization of the upper half of the stomach blocked completely inflow and outflow routes forming the gastric varices. In this clinical study, gastric varices disappeared without recurrence after Hassab's operation. The 5-year cumulative survival rate was 52.14%.

Key words
non shunting operation for solitary gastric varices, endoscopic appearance of solitary gastric varices, portal hemodynamics of solitary gastric varices

Reprint requests
Kaoru Ohashi The Second Department of Surgery, School of Medicine, Juntendo University
2-1-1 Hongo, Bunkyo-kun, Tokyo, 113 JAPAN

Accepted
September 14, 1994

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