Subserosal variceal ligation for gastric varices.

BACKGROUND/AIMS: From the experience of endoscopic examination showing residual gastric varices (GV) after paragastroesophageal devascularization and splenectomy (GEDS) for GV, it was considered that GV could be immediately cleared by additional subserosal variceal ligation (SSVL) after GEDS. We reviewed the outcome of all patients who underwent this surgical technique.

METHODOLOGY: GEDS with SSVL was performed for GV on eight consecutive patients whose esophageal varices had already been treated by endoscopy. After intraoperative endoscopic examination revealed residual GV just after GEDS, the serosal surface was carefully incised by a knife, and GV were exposed, ligated by 3-0 silk and buried by interrupted seromuscular suture (3-0 silk).

RESULTS

In all eight patients, endoscopic examination that was carried out just after SSVL, and after discharge, revealed no intraluminal bleeding and complete disappearance of GV.

CONCLUSIONS

It was concluded that SSVL in addition to GEDS was a simple procedure and was effective for immediate disappearance of GV.