Deterioration of liver function in cirrhotic patients following endoscopic sclerotherapy of esophageal varices.

概要

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Changes of liver functions associated with endoscopic sclerotherapy (EST) was investigated in 50 cirrhotic patients with remarkable esophageal varices. The indices used for the evaluation of hepatic function was the increase of total bilirubin (ΔT. Bil.) in cases who were treated by paravariceal injection of sclerosant and the ratio between the increase of total bilirubin and the increase of LDH (I.I.) in cases treated by intravariceal injection of sclerosant. In a group of patients with preserved hepatic reserve (Group I, 28 cases), Δ T.Bil. was 0.44±0.37mg/dl and I.I. 0.28±0.19, respectively. In contrast, in patients who showed diminished hepatic reserve prior to EST (Group III, 8 cases), a significant deterioration of liver function was observed after EST (Δ T. Bil. 1.65±0.68mg/dl, I.I. 1.01±0.70, p<0.01). Among the patients who revealed hepatic reserve between that of Group I and Group III (Group II, 14 cases), the extent of the deterioration of liver function after EST was also between Group I and III. Recovery of increased serum bilirubin after EST to pre-treatment level was delayed in Group III.It is concluded that the deterioration of liver function can occur after EST among cirrhotic patients especially those with diminished hepatic reserve prior to EST.
財団法人日本消化器病学会の論文