Kunath U, Lackner K
Leber Magen Darm. 1985 Jan;15(1):19-25.
Bleeding esophageal varices are treated in the first line as emergency by sclerosing procedures. Later on shunt surgery is still to be considered as an important definite procedure. Criteria to be met before surgery are discussed. In our experience the shunting procedure as described by Warren yields good results, low incidence of thrombosis and low lethality. In special cases subtotal esophagectomy can be performed, lethality being as low as after the Warren shunt. Repeating sclerosing over years in contrast carries a high risk of complications and death and does not prevent further bleeding safely enough.
出血性食管静脉曲张的一线紧急治疗方法是硬化治疗。之后,分流手术仍被视为一项重要的确定性手术。文中讨论了手术前需满足的标准。根据我们的经验,沃伦(Warren)描述的分流手术效果良好,血栓形成发生率低,致死率也低。在特殊情况下,可以进行食管次全切除术,其致死率与沃伦分流术后一样低。相比之下,多年反复进行硬化治疗会带来较高的并发症和死亡风险,且不能充分安全地预防再次出血。