Esophageal Varices without Hemorrhage in Cirrhosis

AMONG the first 50 surgical portal decompressions carried out for the treatment of esophageal varices at three university-affiliated hospitals in Washington, 18 patients were operated on in the absence of a history of hemorrhage. From the start of a local program to attack varices by definitive surgical shunt procedures, the attitude was adopted that the mere presence of esophageal varices constitutes such a dangerous threat that they should not be permitted to hemorrhage once to fill the requirements for active therapy. The indication for operation in this group was the presence of varices, not a history of hemorrhage.Considerable opposition . . .