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Endoscopic sclerotherapy in control of variceal hemorrhage: a prospective trial in nonselected cirrhotic patients
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Abstract
The aim of this study was to determine the EVS efficacy in the eradication and treatment of bleeding oesophageal varices in patients who underwent endoscopic control in two months during follow-up.
Material and methods: Between 1991 and 2000 a total number of 271 patients of different cirrhosis aetiology (viral 63%, alcoholic 26%, AIH 3.7%, PBC 3%, cryptogenic 3.7%) underwent EVS procedure in two parts. In bleed the first, EVS was done in 3-day intervals up to variceal eradication (no more than 10 procedures) or up to EVS complications. In the cases of no variceal eradication, the second part of treatment was introduced (no more then 10 sclerotherapies). After that, the patients were endoscopically followed up for 48 months in two-month intervals. Retreatment using EVS was introduced if variceal recurrence was found.
Results: Acute haemostasis was achieved in 259 out of 271 patients (95.6%). Six patients died within the first 48 hours of hospitalisation. 131 patients were endoscopically followed up for 48 months regularly while the remaining 101 patients irregularly. 27 patients were lost, there was no information about them. Rebleeding occurred in 52 patients (22.5%). Rebleeding was noted in 32% of patients irregularly followed and in 16% regularly followed (p > 0.05). 77.5% of patients with rebleeding had no full variceal eradication.
Conclusion: EVS is very effective procedure in initial control of oesophageal variceal bleeding. It could also be effective in preventing of rebleeding if endoscopy and EVS are regularly performed in two-month intervals during follow-up.
Abstract
The aim of this study was to determine the EVS efficacy in the eradication and treatment of bleeding oesophageal varices in patients who underwent endoscopic control in two months during follow-up.
Material and methods: Between 1991 and 2000 a total number of 271 patients of different cirrhosis aetiology (viral 63%, alcoholic 26%, AIH 3.7%, PBC 3%, cryptogenic 3.7%) underwent EVS procedure in two parts. In bleed the first, EVS was done in 3-day intervals up to variceal eradication (no more than 10 procedures) or up to EVS complications. In the cases of no variceal eradication, the second part of treatment was introduced (no more then 10 sclerotherapies). After that, the patients were endoscopically followed up for 48 months in two-month intervals. Retreatment using EVS was introduced if variceal recurrence was found.
Results: Acute haemostasis was achieved in 259 out of 271 patients (95.6%). Six patients died within the first 48 hours of hospitalisation. 131 patients were endoscopically followed up for 48 months regularly while the remaining 101 patients irregularly. 27 patients were lost, there was no information about them. Rebleeding occurred in 52 patients (22.5%). Rebleeding was noted in 32% of patients irregularly followed and in 16% regularly followed (p > 0.05). 77.5% of patients with rebleeding had no full variceal eradication.
Conclusion: EVS is very effective procedure in initial control of oesophageal variceal bleeding. It could also be effective in preventing of rebleeding if endoscopy and EVS are regularly performed in two-month intervals during follow-up.
Keywords
liver cirrhosis; endoscopic variceal sclerotherapy
About this articleTitle
Endoscopic sclerotherapy in control of variceal hemorrhage: a prospective trial in nonselected cirrhotic patients
Journal
Chirurgia Polska (Polish Surgery)
Issue
Pages
99-106
Published online
2002-11-08
Page views
1445
Article views/downloads
1288
Bibliographic record
Chirurgia Polska 2002;4(3):99-106.
Keywords
liver cirrhosis
endoscopic variceal sclerotherapy
Authors
Maciej Gonciarz
Jacek Hartleb
Dariusz Gil
Aleksander Michalski
Jan Pruszowski
Jerzy Goniewicz
Anna Witiuk-Misztalska
Aldona Mularczyk
Włodzimierz Mazur
Michał Petelenz
