Percutaneous Transhepatic Variceal Embolization Combined with Partial Splenic Embolization for Treatment of Esophagogastric Variceal Bleeding in Patients with Liver Cirrhosis
10.3969/j.issn.1008-7125.2016.04.002
- VernacularTitle:经皮经肝食管胃底曲张静脉栓塞术联合部分脾栓塞术治疗肝硬化食管胃底静脉曲张破裂出血疗效观察
- Author:
Xiang CHEN
;
Jinhui LI
;
Jianrong XU
;
Jiejun CHENG
;
Qing ZHANG
;
Huawei WU
;
Yunqi YAN
;
Xiaowen ZHOU
;
Shuai ZENG
;
Jun MA
;
Shengliang CHEN
- Publication Type:Journal Article
- Keywords:
Liver Cirrhosis;
Portal Hypertension;
Esophageal and esophagogastric Varices;
Hemorrhage;
Embolization,Therapeutic
- From:
Chinese Journal of Gastroenterology
2016;21(4):197-201
- CountryChina
- Language:Chinese
-
Abstract:
Background:Esophagogastric variceal bleeding is a severe and commonly seen complication of portal hypertension in patients with liver cirrhosis. Prevention of rebleeding remains an important issue in the management of patients suffered from the disease. Aims:To evaluate the efficacy and safety of percutaneous transhepatic variceal embolization(PTVE) combined with partial splenic embolization(PSE)for treatment of esophagogastric variceal bleeding in patients with liver cirrhosis. Methods:Ten liver cirrhosis patients with esophagogastric variceal bleeding were prospectively selected and treated by PTVE combined with PSE. The blood flow of portal system was measured by Doppler ultrasonography pre- and post-operatively;meanwhile peripheral blood cells were counted. A 1-2-year follow-up was carried out and the rebleeding and procedure-related complications were recorded. Results:The postoperative inner diameter of main portal vein,as well as the blood flow velocity of main portal vein and splenic vein were significantly reduced as compared with those before operation(P < 0. 05). Three months after operation,the peripheral white blood cell and platelet were still significantly higher than those before operation(P < 0. 05). During 1-year follow-up,rebleeding appeared in 2 patients,one of them was found having main portal vein thrombosis developed,and was treated by endoscopic esophageal variceal ligation because the gastric varices was not as evident as ever. The rebleeding rate and incidence of portal system thrombosis after the PTVE-PSE procedure was 20. 0% and 10. 0%,respectively. Conclusions:PTVE combined with PSE seemed efficient for alleviating portal hypertension,and might be recommended as a safe and effective interventional therapy for liver cirrhosis patients with esophagogastric variceal bleeding.