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Treatment of Esophageal Varices: A Historical Review Yasuo Idezuki 1 1The Second Department of Surgery, Faculty of Medicine, University of Tokyo pp.469-479
Published Date 1985/5/25
DOI https://doi.org/10.11477/mf.1403109815
  • Abstract
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 The following therapeutic methods have been tried for esophageal varices: (1) to reduce blood flow of the portal system (ligation of artery, splenectomy), (2) to establish bypass for variceal blood flow (non-selective decompression of portal hypertension, selective decompression of portal hypertension, regeneration of collateral veins), (3) disconnection of the esophageal varices from portal system (esophageal transection, endoscopic sclerotherapy, venous embolization) and (4) removal of bleeding sources (total gastrectomy, total esophagectomy).

 The trends of treatment for the esophageal varices have changed from the classical allopathic treatment and non-selective shunt operations, to the selective shunt operations, esophageal transection and endoscopic sclerotherapy during the last two decades. However, indications of these methods as well as their superiority or inferiority over the others are still controversial.

 Therefore, further investigations and experiences seem mandatory to develop better therapy. Here, it seems necessary to consider hyperdynamic state of variceal region, together with the concept of portal hypertension and analysis of collateral hemodynamics of the portal system.


Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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