Abstract
Introduction
Endoscopic oesophageal variceal sclerotherapy (EVS) has been shown to be effective in controlling acute variceal bleeding(1). However, about 10-15 per cent of patients fail to respond to emergency sclerotherapy and continue to bleed. In addition, about 5-10 per cent of patients with portal hypertension bleed from gastric varices after successful obliteration of oesophageal varices and are known to respond poorly to sclerotherapy(2-4). These patients require some form of surgical devascularisation or shunt surgeries to control variceal bleed.
Routine esophago gastric devascularisation procedures are done with splenectomy both in elective and emergency setting. The role of routine splenectomy for all cases of portal hypertension with variceal bleed patients may not be required and splenectomy may infact lead to more complications.
The aim of the current study is to analyse the role of splenectomy in devascularisation procedures and the feasibility to avoid splenectomy in selected cases of portal hypertension and variceal bleed, thereby avoiding the post splenectomy complications.
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Corresponding Author
Prabhakaran R
Institute of Surgical Gastroenterology and Liver Transplant,
Govt Stanley Medical College and Hospital, Chennai, Tamilnadu, India
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.24
