ARE DEVASCULARIZATION AND TRANSSECTION INDICATED IN THE TREATMENT OF BLEEDING ESOPHAGEAL-VARICES

Sugiura procedure and its modfications were performed in 43 patients w ho were not suitable for shunt surgery. Four types of devascularisatio n-transection procedures on the technical basis of Sugiura operation w ere carried out. Thirteen patients died in the early postoperative per iod. Highest mortality was recorded in the standard Sugiura procedure (4/8 or 50%) and the lowest in modified Sugiura III (1/7 or 14 %) whic h is the simpliest form of all. Mortality in the early postoperative p eriod was higher in emergency procedures. No variceal hemorrhage and h epatic encephalopathy were recorded in the early postoperative period. Based on our experience in relatively limited number of cases, the Su giura operation and its modifications are not adventageous in emergenc y conditions and patients with poor liver function. However, these pro cedures can be performed in Child A-B cases. Limiting the extent of th e operation by modifications affects the outcome positively.