الفهرس 
Introduction and Aim of WorkOnly 14 pages are availabe for public view
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Abstract
Variceal hemorrhage is the most dramatic presentation of portal hypertension and potentially fatal occurring in up to one third of patients with liver cirrhosis. Even in specialized centers mortality rates approaches 20-50 % the known conservative measures (balloon tamponade, medical treatment) usually fail to control bleeding in 30-40% of patients. Treatment of variceal hemorrhage is complex, because of the heterogeneous nature of the population & the numerous therapies available. One of the most popular surgical method in Japan is suguiral ’s procedure first described was performed in two stages but nowadays, the operation become easier using single transabdominal approach and mechanical stapler. The aim of this study was to investigate the efficacy, safety, and complications and recurrence rate of varices after transabdominal esophageal transection combined both splenectomy & devascularisation compared with repeated injection sclerotherapy and splenectomy & devasularisation without transaction. The study was conducted on 45 patients 39 males and 6 females with a mean age of 44,2 years with bleeding esophageal varices admitted to Mansoura University & Emergency Hospitals .All patients were subjected to thorough history & clinical examination, full laboratory investigations, upper gastrointestinal endoscopy, abdominal ultrasonography & duplex sonography of the portal system. They were divided into three groups according to the line of management group I pateints were treated by splenectomy & devascularization without transection while group II had went transabdominal esophageal transection + splenectomy & devasularisation and group III patients were managed by long term sclerotherapy. All patients were followed up for at least one year. Mortality &survival: in group I patients no mortality was recorded, one case only died in group II patients while 2 cases in group III patients. Operative time, hospital stay & blood transfusion was least and better.