Variceal recurrence, rebleeding rates and alterations in clinical and laboratory parameters following post-variceal obliteration using endoscopic sclerotherapy.

Abstract

OBJECTIVE:

To study the rates of variceal recurrence and rebleeding following sclerotherapy and its effect on clinical and laboratory parameters in patients with portal hypertension.

METHODS:

A total of 237 patients with portal hypertension together with esophageal variceal bleeding were included in the study. There were 138 patients with cirrhosis (group I), 42 with non-cirrhotic portal fibrosis (group II), and 57 with extrahepatic portal vein obstruction (group III). Baseline data and post-obliteration follow-up for rebleeding rates and changes in clinical and laboratory parameters were recorded.

RESULTS:

In all, 106 patients in group I, 31 in group II and 43 in group III experienced obliteration of varices. The recurrence of grade II varices occurred in 17 patients (9.4%) during a mean period of 9 months. Rebleeding from varices was observed in 4 patients (3.8%) in group I and 1 (3.2%) in group II, while none in group III experienced rebleeding. There was a significant improvement in ascites, jaundice, liver status, international normalized ratio and platelet count in group I patients after variceal eradication (P < 0.05). The main cause of death in the cirrhotic patients was active liver disease but not rebleeding.

CONCLUSIONS:

Following obliterative endoscopic sclerotherapy, rates of recurrence and rebleeding were significantly low when patients are kept under close observation. Disappearance of varices or reduction of variceal size improves the liver status in surviving cirrhotic patients.

• Authors: Arunkumar Krishnan, Vijaya Srinivasan, Jayanthi Venkataraman
• Journal: Journal of digestive diseases (J Dig Dis) Vol. 13 Issue 11 Pg. 596-600 (Nov 2012) ISSN: 1751-2980 [Electronic] Australia
• PMID: 23107447 (Publication Type: Journal Article)
• Copyright: © 2012 The Authors. Journal of Digestive Diseases © 2012 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Topics

• Adolescent
• Adult
• Aged
• Child
• Endoscopes, Gastrointestinal
• Esophageal and Gastric Varices (mortality, therapy)
• Female
• Follow-Up Studies
• Gastrointestinal Hemorrhage (mortality, therapy)
• Humans
• Hypertension, Portal (mortality)
• India (epidemiology)
• Liver Cirrhosis (mortality)
• Male
• Middle Aged
• Portal Vein
• Sclerotherapy (methods)
• Secondary Prevention
• Treatment Outcome
• Young Adult