Therapeutic Efficacy of Balloon-Occluded Retrograde Transvenous Obliteration in the Treatment of Gastric Varices in Cirrhotic Patients with Gastrorenal Shunt.
- Author:
Gwang Ho BAIK
1
;
Dong Joon KIM
;
Ho Gwon LEE
;
Seul Ki MIN
;
Seung Jin KONG
;
Jin Bong KIM
;
Ja Young LEE
;
Tae Ho HAHN
;
Il Hyun BAEK
;
Jong Hyeok KIM
;
Bong Soo KIM
;
Woo Cheol HWANG
Author Information
1. Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea. djkim@hallym.ac.kr
- Publication Type:Original Article ; English Abstract
- Keywords:
Balloon-occluded retrograde transvenous obliteration (B-RTO);
Gastric varices;
Gastrorenal shunt;
Liver cirrhosis
- MeSH:
Adult;
Aged;
*Balloon Occlusion;
Endoscopy, Digestive System;
English Abstract;
Esophageal and Gastric Varices/diagnosis/*therapy;
Female;
Gastrointestinal Hemorrhage/etiology/*therapy;
Humans;
Liver Cirrhosis/*complications;
Male;
Middle Aged
- From:The Korean Journal of Gastroenterology
2004;43(3):196-203
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Rupture of gastric varices was one of the most dreadful complications of cirrhosis. Recently, a new interventional procedure, balloon-occluded retrograde transvenous obliteration (B-RTO) was introduced for the treatment of gastric variceal bleeding. This study was performed to evaluate the therapeutic efficacy of B-RTO in the treatment of gastric varices with gastro-renal shunts. METHODS: From March 2000 to June 2003, we performed B-RTO in 17 patients with gastric varices and gastrorenal shunts. All patients had history or high risk factors of gastric variceal bleeding. For the evaluation of therapeutic efficacy, we performed esophagogastroduodenoscopy (EGD) and computed tomography (CT) at 1, 6 and 12 months after B-RTO. Successful B-RTO was judged by combined CT findings and EGD findings (disappearance of gastric varices or markedly reduced gastric variceal size or bleeding risk) during follow-up periods (1-14 months, mean:6.18). We analyzed the clinical factors related to clinical success of B-RTO. RESULTS: Technical success were achieved in all patients except one (94.1%). Gastric varices were disappeared or decreased after B-RTO in 13 patients (81.2%). Complications related to procedure included transient hematuria (n=5), puncture site oozing (n=1) and partial splenic infarction (n=1), and all were conservatively managed. During the follow up periods, neither significant hepatic nor renal functional damages occurred. Statistically, no significant factors related with B-RTO success. CONCLUSIONS: B-RTO is effective and safe in the management of gastric varices in cirrhotic patients with gastrorenal shunt.
