Direct vision controlled gastric coronary vein embolization for the treatment of portal hypertension.

Complications of gastric mucosal bleeding and ectopic embolism occurred in gastric coronary embolization under direct vision in treating hemorrhage from ruptured esophageal varices though it has been widely used with satisfactory results. 40 patients with portal hypertension were treated by splenectomy and gastric coronary vein embolization under direct vision in this hospital. On the basis of Liu's operative method, 20 of the 40 patients underwent controlled embolization of the gastric coronary vein with satisfactory results. The technic not only occluded the predicted bleeding sites of the veins at the esophageal and gastric fundic regions but also blocked its communication with surrounding veins. Thus serious complications were reduced or prevented. The effectiveness of devascularization derived from the technic in question, the detailed maneuver of the procedure, and prevention of complications are discussed.