The choice of operation in the surgical management of ruptured esophageal varices has been the center of the most enduring controversies in theory and practice. We introduced a t chnique of splenectomy, pericardial devascularization, vagotomy, cardi-ac transection and anastomosis with a circular stapling instrument, and pyloroplasty as a definitive treatment for bleeding esophageal varices both electiv ly and as an emer gency procedure in a total of 11 cases, between December 1982 and October 1984.Re- currence of bleeding and portal systemic enccphalopathy has not been detected in any of these 9 living cases over a follow up period of 1-24 months(average 14.1 months). Esophageal varices were either disappeared or improved as demonstrated by repeated-barium examinations.The merits and demerits of this technique are discussed.Although thsresults obtained are encouraging,definite conclusion can only be reached by further accumulation of clinical experience.

Pulmonary edema is associated with pancreatic enzymes released into the blood stream during acute pancreatitis.Acute hemorrhagic pancreatitis in rats was established by injecting 5%sodium taurocholate into the pancreatic duct.Before and at the time of induction,SMS201-995 2?g/kg was injected subcutaneously,and followed by 3 h continuous I.V.infusion of NS solution containing SMS201-995 5?g?kg-1?h-1 at a rate of 6ml?kg-1?h-1.The results of this experiment showed that SMS201-995 could:(1) decrease the serum levels of amylase and lipase effectively;(2)reduce lung index and lung extravascular water volume siginficantly;(3)ameliorate the pathologic changs of lung and pancreas evidently.These results also suggested that SMS201-995 could both prevent and treat acute pancreatitis and pulmonary edema induced by it in rats.Therefore,it is theoretically sound that evidence can be proviede by the results obtained in this experiment for the application of SMS201-995,a long acting analogue of somatostatin,to treat clinical acute pancreatitis by its inhibitory effect towards pancreatic exocrine secretion.