Prevention of Recurrent Variceal Bleeding—Is Surgical Rescue the Answer?

Editorials15 February 1990Prevention of Recurrent Variceal Bleeding—Is Surgical Rescue the Answer?Norman D. Grace, MDNorman D. Grace, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-112-4-242 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptBleeding from esophageal varices continues to be a major complication of cirrhosis and portal hypertension, with the mortality for a bleeding episode close to 50% (1). Although the risk for first hemorrhage after discovery of esophageal varices is 25% to 30%, the risk for recurrent variceal hemorrhage after control of the initial bleeding episode is close to 70% (2). Most episodes of recurrent hemorrhage occur within 1 year of the initial episode. Because of the high morbidity associated with variceal bleeding, there is considerable interest in finding a therapy that will both prevent variceal bleeding and improve survival.Several prospective...References1. GrahamSmith DJ. The course of patients after variceal hemorrhage. Gastroenterology. 1981;80:800-9. CrossrefMedlineGoogle Scholar2. Grace N. The prevention of initial variceal bleed: the knife, the scope, or the pill. In: Najarian JS, Delaney JP, eds. Progress in Hepatic Biliary and Pancreatic Surgery. Chicago: Yearbook Medical Publishers; 1990 [In press]. Google Scholar3. JacksonPerrinFelixSmith FEWA. A clinical investigation of the portacaval shunt. V. Survival analysis of the therapeutic operation. Ann Surg. 1971;174:672-701. CrossrefMedlineGoogle Scholar4. ResnickIberIshiharaChalmersZimmerman RFATH. A controlled study of the therapeutic portacaval shunt. Gastroenterology. 1974;67:843-57. CrossrefMedlineGoogle Scholar5. ReynoldsDonovanMikkelsenRedekerTurrillWeiner TAWAFJ. 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SpinaGaleottiOpocher GFE. Selective distal splenorenal shunt versus side-to-side portacaval shunt. Clinical results of a prospective, controlled study. Am J Surg. 1988;155:564-71. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Faulkner and Lemuel Shattuck Hospitals Tufts University School of Medicine Boston, MA 02130 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 February 1990Volume 112, Issue 4Page: 242-244 Issue Published: 15 February 1990 PDF DownloadLoading ...