“Study results indicate that the modified Sugiura procedure is an effective rescue therapy in patients who are not candidates for selective shunts, transhepatic porto-systemic shunt, or transplantation. Emergency settings and decreased liver function are associated with an increased morbidity.”

“The Sugiura procedure is based on the principle of dividing the perforating veins of the esophagus and the stomach while maintaining the plexus of collaterals that connect the coronary vein to the azygous system. In particular the left gastric vein must be preserved during the gastric devascularization to allow drainage into the azygos vein. Although the initial results with this procedure were exceptional in terms of mortality, morbidity, and recurrent bleeding, surgeons outside of Japan have had difficulty reproducing these results.”

Selzner M, et al . Current indication of a modified Sugiura procedure in the management of variceal bleeding. J Am Coll Surg. 2001 Aug;193(2):166-73. Full Text for Emory Users