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The long-term outcome of patients with bleeding gastric varices after balloon-occluded retrograde transvenous obliteration.

Abstract：

BACKGROUND:The purpose of our study was to evaluate the long-term outcome and complications of balloon-occluded retrograde transvenous obliteration (B-RTO) in patients with hemorrhage from gastric fundal varices. METHODS:Thirty-four consecutive patients with bleeding from gastric varices who were treated with B-RTO were enrolled in this study between December 1994 and September 2005 (urgent cases, n = 12; elective cases, n = 22). The long-term outcome, complications, and various liver functions were evaluated. RESULTS:Complete obliteration was achieved in 31 of 34 (91%) patients with an acute bleeding episode. In one of the remaining patients, there was a technical failure, and the other two had only partial obliteration. The two patients with partial obliteration did not obtain hemostasis. Thus, the rate of hemostasis was 94% (31/33). Gastric varices disappeared in all patients with complete obliteration during the treatment. The rate of gastric variceal eradication was 91%. Variceal rebleeding from esophageal varices occurred in three patients. The rate of rebleeding was 10% (3/31). Rebleeding from gastric varices was not observed after complete obliteration. None of the patients showed worsening of their Child-Pugh score. Although the 5-year cumulative worsening rate of esophageal varices was 52%, neither portal hypertensive gastropathy nor ectopic varices were observed. The patients with worsening esophageal varices were successfully treated with an endoscopic procedure. The 5-year survival rate was 68%. CONCLUSIONS:B-RTO is useful for treatment of bleeding gastric varices, achieving high eradication of gastric varices, a low rebleeding rate, and a fairly good prognosis with improved hepatic function.

journal_name

J Gastroenterol

journal_title

Journal of gastroenterology

authors

Hiraga N,Aikata H,Takaki S,Kodama H,Shirakawa H,Imamura M,Kawakami Y,Takahashi S,Toyota N,Ito K,Tanaka S,Kitamoto M,Chayama K

doi

10.1007/s00535-007-2077-1

subject

Has Abstract

pub_date

2007-08-01 00:00:00

pages

663-72

issue

eissn

0944-1174

issn

1435-5922

journal_volume

pub_type

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The long-term outcome of patients with bleeding gastric varices after balloon-occluded retrograde transvenous obliteration.