Evaluation of the efficacy of inflatable balloon compression-assisted endoscopic injection sclerotherapy in the treatment of 38 cases of esophago-gastric fundal varices
10.3760/cma.j.cn311367-20210602-00316
- VernacularTitle:可充气球囊压迫辅助下硬化剂注射治疗38例食管-胃底静脉曲张的疗效评价
- Author:
Yi XIANG
1
;
Wenyue WU
;
Qianqian ZHANG
;
Zexue WANG
;
Fumin ZHANG
;
Derun KONG
Author Information
1. 安徽医科大学第一附属医院消化内科，合肥 230022
- Keywords:
Liver cirrhosis;
Esophageal and gastric varices;
Balloon;
Sclerotherapy
- From:
Chinese Journal of Digestion
2021;41(12):812-816
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of inflatable balloon compression-assisted endoscopic injection sclerotherapy (bc-EIS) in the treatment of esophago-gastric fundal varices (EGV).Methods:From June 12 to September 12, 2020, at the First Affiliated Hospital of Anhui Medical University, 38 patients with EGV who underwent bc-EIS were prospectively selected, the amount and the injection points of sclerosing medication were calculated, whether the injection point was bleeding during operation (no bleeding, oozing, spurting), whether compression was needed to stop bleeding (no need, needle sheath compression to stop bleeding, transparent cap compression to stop bleeding), early rebleeding after operation (72 h to 6 weeks after operation), delayed bleeding (six weeks after operation) were observed, and the number of treatments to achieve the complete elimination of varices were recorded. The postoperative follow-up period was one, three and six months to evaluate the efficacy and complications of bc-EIS. Descriptive methods were used for statistical analysis.Results:Among the 38 patients with EGV, there were 24 males and 14 females, aged (53.2±11.3) years old (ranged from 30 to 79 years old). During bc-EIS operation, the dosage of sclerosing medication of each patient was (20.03 ±7.49) mL (ranged from 6 to 40 mL), and the injection points of sclerosing medication were 4.97±1.83 (ranged from 2 to 10). The rates of complete disappearance of varices after the first, second and third time of bc-EIS were 71.1% (27/38), 89.5% (34/38) and 100.0% (38/38), respectively. Among the 38 patients with EGV, no postoperation varices related rebleeding occurred. During the follow-up two patients had hematemesis and melena within one month after operation. The endoscopic diagnosis was gastric varices bleeding below the cardia, which was improved after tissue glue injection under endoscopy. No severe adverse reactions such as fever, spontaneous bacterial peritonitis, hepatic encephalopathy, ectopic embolism, or death occurred in all patients after bc-EIS treatment.Conclusions:The dosage of sclerosing medication in bc-EIS is reduced by half compared with the recommended amount in the guidelines, and the injection point bleeding is less, moreover, the rate of complete disappearance rate of esophageal varices is more than 70% after the first treatment.
