Clinical Study on Timing of Re-treatment of Endoscopic Selective Varices Devascularization for Esophageal and Gastric Varices (Sarin Type GOV1 and GOV2)
10.3969/j.issn.1008-7125.2020.01.008
- Author:
Yiping HONG
1
Author Information
1. Department of Gastroenterology, Jinhua Municipal Central Hospital
- Publication Type:Journal Article
- Keywords:
Endoscopic Selective Varices Devascularization;
Esophageal and Gastric Varices;
Liver Cirrhosis
- From:
Chinese Journal of Gastroenterology
2020;25(1):40-42
- CountryChina
- Language:Chinese
-
Abstract:
Background: Liver cirrhosis complicated with esophageal and gastric variceal bleeding is a commonly seen critical illness. Gastrointestinal endoscopy is widely applied for bleeding control and prevention of rebleeding. Aims: To investigate the timing of re-treatment of endoscopic selective varices devascularization (ESVD) for treatment of esophageal and gastric varices presenting as Sarin type GOV1 and GOV2. Methods: Forty-eight cirrhotic patients with GOV1 or GOV2 varices and a history of bleeding admitted from October 2018 to September 2019 at Jinhua Municipal Central Hospital were enrolled and underwent ESVD therapy for secondary prevention. After the first ESVD procedure, patients were randomly allocated into two groups, and received the re-treatment 2 weeks (Group A) and 4 weeks (Group B) later, respectively. All patients were followed up for 6 months and the efficacy of ESVD, as well as the rebleeding rate and the mortality rate were compared between the two groups. Results: There was no significant difference in devascularization of varicose veins between Group A and Group B (76.9% vs. 81.8%, P>0.05). The incidence of rebleeding in Group A was significantly lower than that in Group B during the 6-month follow-up (11.5% vs. 36.4%, P<0.05). No death occurred in both groups. Conclusions: ESVD is effective for secondary prevention of GOV1 and GOV2 variceal bleeding. With regard to the timing of re-treatment, short-term (2 weeks postoperatively) re-treatment might reduce the probability of rebleeding because it could deal with the high risk and vulnerable bleeding vessels earlier.
