Ungeheuer E, Peglow H J
Langenbecks Arch Chir. 1976 Nov 15;342:167-71. doi: 10.1007/BF01267364.
If it is not possible to arrest massive hemorrhage from esophageal varices within 48 h by conservative means or by endoscopic phlebosclerosation, surgery should be performed as soon as possible. In most cases a palliative operation is performed, by which irreversible shock and consequent heart failure can be avoided. The method of phlebosclerosation preferred by the authors is transection of the lower esophagus via a thoracic approach.