ABSTRACT
Nineteen patients [Child's A or B grade] with previous variceal bleeding underwent an elective gastro-esophageal devascularization and esophageal transection over two years period. Eight of them [42%] had recurrent bleeding despite medical therapy. There were neither operative death nor intraoperative complications. No anastomotic leakage was observed from the transection line. Nine patients [47%] had 16 postoperative complications. Routine ultrasonography following surgery showed portal vein thrombosis in three patients [16%]. In one patient, this has resulted in a late postoperative death due to mesenteric vein thrombosis. Follow-up endoscopy on the third postoperative month, showed that 42% of the patients had no visible varices and all patients except one showed marked reduction in the grade of esophageal varices. The study suggests that gastro-esophageal devascularization and esophageal transection carries a low operative risk and results in good prevention of recurrent variceal bleeding. The authors believe that this procedure deserves greater attention and can be used for the management of Egyptian patients with esophageal varices who may require surgery. A longer period of evaluation in a larger series of patients is required