Efficacy of percutaneous transhepatic variceal embolization in treating esophageal and gastric variceal bleeding after esophageal-gastric devascularization with splenectomy
10. 3760/cma:j. issn::0254-1432. 2009.04. 007
- VernacularTitle:经皮经肝曲张静脉栓塞治疗断流术后食管胃底静脉破裂出血的疗效
- Author:
Yuzheng ZHUGE
;
Xiaoping ZOU
;
Yulin WU
;
Jianwu ZHANG
;
Min XIE
;
Min WU
;
Zhaomin XU
- Publication Type:Journal Article
- Keywords:
Gastrointestinal hemorrhage;
Esophageal and gastric varices;
Therapeutic embolization
- From:
Chinese Journal of Digestion
2009;29(4):241-244
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the efficacy of percutaneous transhepatie variceal embolization (PTVE) in treating esophageal and gastric variceal bleeding after esophageal-gastric devascularization with splenectomy in patients with liver cirrhosis. Methods Twenty-two patients, who had history of esophageal-gastric devascularization with splenectomy, were either underwent PTVE with TH glue (n=10) or endoscopic injection of sclerosis (EIS, n = 12) for treatment of esophageal or gastric variceal rebleeding between Nov. 2006 and Sep. 2008. The patients were followed-up for recurrent bleeding, mortality, grade of esophageal and gastric varices and liver function. Portal vein pressure was measured before and after collateral embolization in PTVE group. Results ① The patients were followed-up for 12.5 months in PTVE group and 13.4 months in EIS group. There was significant difference (P<0.05) between PTVE and EIS groups in rebleeding rate (1/10 vs 7/12) and mortality (0 vs 3/12). ② The degree of esophageal and gastric varices after embolization or EIS was improved significantly. ③ For patients with portal vein thrombosis, combination of PTVE with portal vein balloon plasty could markedly improve portal vein blood supply. ④ Neither PTVE nor EIS aggravated the liver cirrhosis. Conclusion Compared with EIS, PTVE with TH glue may be a more effiective method in the treatment of rebleeding of patients with liver cirrhosis who had accepted esophagealgastric devascularization with splenectomy.
