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  Česky / Czech version Rozhl. Chin, 2005, roč. 84, č. 4, s. 193-196
 
Cooperation between a Surgeon and a Gastroenterologist in the Management of Vascular Complications of the Liver Cirrhosis 
Chlapík D.i, Hlista M.2 

1 Chirurgické oddelenie nemocnice Trenčín, Slovenská republika, primář MUDr. D. Chlapík, PhD. 2 Gastroenterologická ambulancia nemocnice Trenčín, Slovenská republika, primář MUDr. O. Herman
 


Summary:

       Aim: The aim of this work was to confirm indications for surgical procedures in cases of relapsing bleeding from oesop-hageal varices as a consequence of the liver cirrhosis. Methodology: Based on the retrospective study of the endoscopical examinations results and the patient records, the cri-teria of the patient selection for the surgical proceduře, the type of the surgical proceduře, the postoperative complications and the long-term assessment, were revised. Results: During the six-year period, 7625 gastrofibroscopies were conducted. In this group, the oesophageal varices were diagnosed in 107 males and 47 females. In 76 males and 31 females the varices did not bleed. In 31 males and 16 females the varices did bleed and were sclerotised. In this subgroup, in 24 males and 13 females the varices were eradicated or moved from the Paquet grade 3-4 to 1-2. In 3 females and 7 males the sclerotherapy was not successful and the patients continued to bleed. Five males underwent surgery and 2 males and 3 females exsanguinated without surgery. The following surgical procedures were completted: 3x Warren anastomoses, lx Linton anastomosis and lx resection of the duodenojejunal arcuation. One patient exited due to the liver failure. Conclusion: The sclerotherapy failed in 21.3% patients. Haif of them exsanguinated. Only patients in the Child-Pugh A and B functional stage are indicated for the elective surgical proceduře in cases of bleeding relapses following the sclerotherapy, varices of the gastric fundus and haemorrhaging gastropathy. Ablation is the method of choice in cases of emergency

        Key words: bleeding varices of the oesophagus and stomach - sclerotherapy - surgical treatment - indications
       

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