A long-term follow-up of portal hemodynamics after endoscopic treatment for esophageal varices

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A long-term follow-up of portal hemodynamics was made during a period of 3.6 ± 3.3 years in 95 patients who underwent endoscopic treatment for esophageal varices using digital subtraction angiography.<BR>The study concluded that (1) The recurrence rate of esophageal varices in patients with extravariceal collaterals before endoscopic treatment tended to be lower than that in patients without collaterals (<I>p</I> = 0.23). In contrast, formation of new extravericeal collaterals after endoscopic treatment didn't have any influences on the reduction of the recurrence rate of esophageal varices. (2) The incidence of complete obstruction of left gastric vein confirmed by angiography was 0 % in patients whose direction of left gastric vein before endoscopic treatment was hepatofugal or undetermined. While the incidence was approximately 20 % in patients whose direction of LGV before endoscopic treatment was hepatopetal or to-and-fro. (3) The blood flow of left gastric vein was hepatofugal or undetermined in approximately half of the patients with recurrent esophageal varices, and, it was hepatopetal or to-and-fro in the remaining patients.<BR>These results suggest that the presence of collaterals and the direction of left gastric vein independently affect the recurrence of esophageal varices.
The Japan Society for Portal Hypertensionの論文