[Azygo-portal disconnection by the abdominal route]

Abstract

Azygo-portal disconnection by the abdominal route consists of devascularization of the lower oesophagus, cardiac orifice and greater gastric tuberosity by ligation of the varices and section of the oesophagus, combined in every case with truncular vagotomy and gastric bypass. In emergencies the abdominal approach enables the bleeding points to be accurately localized. In the treatment of haemorrhages due to portal hypertension, this technique offers an alternative to porto-caval bypasses when these cannot be performed (thrombosis or portal cavernoma) or when the risk of encephalitis is too high. However, contrary to liver transplantation, it is a palliative technique for cirrhotic patients.