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Zur therapie der Ösophagusvarizenblutung in der Bundesrepublik Deutschland (West) — Ergebnisse einer Urnfrage

Therapy of esophageal variceal bleeding in West Germany

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Summary

An inquiry concerning bleeding of esophageal varices included 1076 surgical and medical departments in the Federal Republic of Germany (West). Prevailing forms of treatment are acute sclerotherapy or esophageal balloon tamponade followed by long-term sclerotherapy. In case of medically uncontrollable bleeding oesophagogastric devascularization procedures are preferred to portacaval shunt. Beta-blockers are applied in medical departments for the prophylaxis of recurrence. Only after several rebleedings, despite of sclerotherapy, approx. half of the departments consider an elective shunt. The distal splenorenal shunt described by Warren and portacaval anastomosis clearly prevail over all other shunts.

Zusammenfassung

An 1076 chirurgischen und internistischen Abteilung in der BRD (West) wurde eine Umfrage zur Behandlung der Ösophagusvarizenblutung durchgeführt. Es überwiegt die Akutsklerosierung bzw. die Ballonsondenbehandlung mit nachfolgender Sklerosierung bei der aktiven Blutung. Die abdominelle Sperroperation wird bei der konservativ nicht stillbaren Blutung noch vor dem portokavalen Notshunt bevorzugt. Betablocker werden vor allem in internistischen Abteilungen zur Rezidivprophylaxe eingesetzt. Erst nach mehrfacher Rezidivblutung trotz Sklerosierung sehen etwa die Hälfte der Abteilungen eine Indikation zum elektiven Shunt. Der distale splenorenale Shunt nach Warren and die portokavale Anastomose dominieren deutlich gegenüber den anderen Shuntformen.

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  1. Klinik and Poliklinik für Allgemein- und Abdominalchirurgie, der Johannes-Gutenberg-Universität, Langenbeckstraße 1, W-6500, Mainz, BRD

    K. W. Steegmüller, D. Schmidt & Th. Junginger

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  3. Th. Junginger
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Steegmüller, K.W., Schmidt, D. & Junginger, T. Zur therapie der Ösophagusvarizenblutung in der Bundesrepublik Deutschland (West) — Ergebnisse einer Urnfrage. Langenbecks Arch Chir 376, 273–279 (1991). https://doi.org/10.1007/BF00188267

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  • DOI: https://doi.org/10.1007/BF00188267

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