Combined therapy for esophageal varices: sclerotherapy, embolization, and splenopneumopexy.

A new approach consisting of sclerotherapy, embolization, and splenopneumopexy was designed to treat esophageal varices, which were caused by cirrhosis of the liver in 13 patients and by idiopathic portal hypertension in three. No serious complications occurred. Fifteen of the patients were well and without recurrent bleeding or encephalopathy during the 29-month follow-up period. One patient died of hepatic failure 4 months postoperatively. The varices either disappeared or were significantly improved. Placement of a portopulmonary shunt by splenopneumopexy is a safe, simple, and effective procedure for the resolution of varices that recur following sclerotherapy.