EFFECT OF GASTROESOPHAGEAL DECONGESTION ON VARICEAL PRESSURE IN PATIENTS WITH SCHISTOSOMAL HEPATIC-FIBROSIS

This study includes 60 patients having schistosomal hepatic fibrosis a nd esophageal varices. Splenectomy alone was done for 14 patients havi ng no history of haematemesis and gastroesophageal decongestion with s plenectomy was done for the remaining 46 patients with history of haem atemesis. Endoscopic variceal pressure measurements were done to all o f them peroperatively and 21 days postoperatively. 17 patients, 7 afte r splenectomy and 10 after gastro-esophageal decongestion, were follow ed for 18 months post operatively. 21 days postsplenectomy, the varice al pressure dropped insignificantly from 38.09 to 33.27 cm H2O. During the following 18 months, three patients out of seven showed significa nt increase in variceal pressure. After decongestion with splenectomy, the mean variceal pressure dropped significantly from 42.03 to 29.17 cm H2O. For the 10 patients followed for 18 months, eight of them reta ined their variceal pressure as low as early postoperative figures. Th us gastro-esophageal decongestion with splenectomy is effective in red ucing variceal pressure and in so doing it is better than splenectomy alone.