SURGERY AS A LAST RESORT OPTION FOR ACTIVE VARICEAL BLEEDING FURTHER COMPLICATED BY IATROGENIC ESOPHAGEAL-PERFORATION

Despite the advent of transjugular intrahepatic portosystemic stent sh unting (TIPPS)(1,2) for variceal bleeding and the wide use of injectio n sclerotherapy, combined with other medical therapies, patients with active variceal bleeding not responding to endoscopic or radiologic th erapies are still referred to surgeons. The emergency surgical strateg y adopted for five patients referred when emergency TIPSS was still un der prospective evaluation is described.