Long-term follow-up of patients with liver cirrhosis after endoscopic esophageal varices ligation therapy: comparison with ethanol injection therapy.

Abstract

BACKGROUND/AIMS:

Esophageal variceal hemorrhage is the most dreaded complication of liver disease. Prevention or emergency therapy of bleeding is important.

METHODOLOGY:

A group of 217 patients underwent endoscopic esophageal variceal therapy including endoscopic ethanol injection, endoscopic esophageal variceal ligation, or a combination of the two.

RESULTS:

Esophageal varices were eradicated by endoscopic esophageal variceal ligation with the least sessions required, and associated complications with endoscopic esophageal variceal ligation therapy were lower than with the other two approaches. However, the cumulative recurrence-free period of esophageal varices was significantly higher after endoscopic ethanol injection than after endoscopic esophageal variceal ligation and in some cases F3 varices were observed post-endoscopic esophageal variceal ligation hemorrhage. A combined endoscopic esophageal variceal ligation and endoscopic ethanol injection therapy had no advantage with respect to cumulative recurrence-free rate, session number, or complication frequency, relative to either therapy alone.

CONCLUSIONS:

While the combined observations indicate that endoscopic esophageal variceal ligation is safe and simple, we should consider additional therapy to achieve complete mucosal fibrosis of the esophagus after endoscopic esophageal variceal ligation.

• Authors: Hiroshi Okano, Katsuya Shiraki, Hidekazu Inoue, Tomoyuki Kawakita, Masatoshi Deguchi, Kazushi Sugimoto, Takahisa Sakai, Shigeru Ohmori, Kazumoto Murata, Takeshi Nakano
• Journal: Hepato-gastroenterology (Hepatogastroenterology) 2003 Nov-Dec Vol. 50 Issue 54 Pg. 2013-6 ISSN: 0172-6390 [Print] Greece
• PMID: 14696455 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Oleic Acids
• ethanolamine oleate

Topics

• Adult
• Aged
• Cause of Death
• Combined Modality Therapy
• Esophageal and Gastric Varices (mortality, therapy)
• Esophagoscopy
• Esophagus (blood supply)
• Female
• Follow-Up Studies
• Gastrointestinal Hemorrhage (mortality, therapy)
• Humans
• Ligation
• Liver Cirrhosis (complications, etiology, mortality, therapy)
• Male
• Middle Aged
• Oleic Acids (administration & dosage)
• Outcome and Process Assessment, Health Care
• Prognosis
• Sclerotherapy
• Secondary Prevention
• Survival Rate