Abstract:
BACKGROUND:Cyanoacrylate injection is highly effective and is regarded as the treatment of choice in bleeding gastric varices in Europe, but intravenous injection of cyanoacrylate is not allowed in the USA and Japan because it may cause embolisms in other organs. Accordingly, we developed a new endoscopic combined treatment of endoscopic management of gastric varices using a detachable snare (EVLs) and simultaneous endoscopic sclerotherapy and O-ring ligation (EISL) (i.e. EVLs + EISL), and we prospectively evaluated its efficacy and safety. METHODS:Gastric varices were ligated with the loop of a detachable snare that opened to a diameter of 4 cm (EVLs). Then the residual varices around the ligated portion were sclerosed by ethanolamine oleate and the injected vessel was ligated using a pneumo-activated EVL device (EISL). The EVLs + EISL was performed in 35 patients: on an emergency basis in eight patients, on an elective basis in six patients and as primary prophylaxis in 21 patients. Liver function was classified as Child-Pugh class A in 12 patients, class B in 12 patients and class C in 11 patients. RESULTS:Endoscopic disappearance of gastric varices was obtained in 97.1% of the patients and they regressed in all patients. Haemostasis was achieved in all eight emergency cases. The 2-year cumulative non-recurrence rate was 85%, the 2-year cumulative non-bleeding rate was 92% and the 2-year cumulative survival was 80%. No patients died of bleeding from gastric varices. There were no serious short-term complications, such as haemorrhage, gastro-oesophageal perforation, ileus, or renal impairment. CONCLUSION:Combined EVLs + EISL appears to be a useful treatment for gastric varices due to its safety and good clinical outcome.
journal_name
J Gastroenterol Hepatoljournal_title
Journal of gastroenterology and hepatologyauthors
Yoshida T,Harada T,Shigemitsu T,Takeo Y,Miyazaki S,Okita Kdoi
10.1046/j.1440-1746.1999.01941.xsubject
Has Abstractpub_date
1999-07-01 00:00:00pages
730-5issue
7eissn
0815-9319issn
1440-1746journal_volume
14pub_type
临床试验,杂志文章abstract::A series of 51 patients with achalasia of the oesophagus treated by pneumatic dilatation between 1980 and 1988 is reported. Treatment was assessed as effective (no or minimal dysphagia) in 78% of patients, followed for a mean of 30 months. Thirty-four patients required only one dilatation and only two patients had mor...
journal_title:Journal of gastroenterology and hepatology
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journal_title:Journal of gastroenterology and hepatology
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章,评审
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更新日期:2013-02-01 00:00:00
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