Oesophageal transection involves the removal of the lower 5 cm of the oesophagus with end-to-end anastomosis with a stapling gun.
This is a simple operation relative to portal-systemic shunts and is associated with a lower operative mortality. Hepatoencephalopathy is a relatively uncommon complication.
Acute bleeding is controlled in 95% of patients but about 30% of patients will rebleed. Rebleeding is less common if transection is combined with extensive oesophageal and gastric devascularisation, pyloroplasty, vagotomy and splenectomy (the Sugiura operation).
Oesophageal transection is most suitable for patients:
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