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Gastro-esophageal decongestion and splenectomy GEDS (Hassab), in the management of bleeding varices. Review of literature.

Authors: M A, Hassab;

Gastro-esophageal decongestion and splenectomy GEDS (Hassab), in the management of bleeding varices. Review of literature.

Abstract

The use of Doppler flowmetry proved the importance of hypervolemia in bleeding and showed that GEDS enhances liver perfusion confirming our findings in the Sixties. Perhiatal devascularization of lower 3-4 inches of the esophagus, complete separation of the stomach from its bed, ligation of the left gastric artery at the lesser curvature, peritonization of greater curvature, nursing the patient on his right side, suction drainage of the splenic bed, and early respiratory exercises are essential technical points. Combination with sclerotherapy is useful but esophageal transection is harmful. Variceal rebleeding varied from 5.5% in 3 years to 7% in 10 years, when done properly, to 17% and 18.8% when done incompletely; higher rates include minor bleeding of gastritis. Encephalopathy varied from nil to minimal incidence of mild forms. Thus when done properly GEDS is as effective in controlling bleeding as DSRS with better liver, better heart, better life and better survival with nil or minimal encephalopathy. Combined with sclerotherapy it forms the ideal therapy for bleeding varices in all types of pathology.

Related Organizations
Keywords

Esophagus, Regional Blood Flow, Liver Diseases, Stomach, Splenectomy, Humans, Schistosomiasis, Esophageal and Gastric Varices, Gastrointestinal Hemorrhage

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
29
Average
Top 10%
Top 10%
gold