Clinical Evaluation of Endoscopical Treatment for Esophago-gastric Varices in Patients with Tumor Invasion in the Portal Vein Trunk or First Portal Branches Associated with Hepatocellular Carcinoma
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概要
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A clinical evaluation of endoscopic treatment for esophago-gastric varices in hepatoma patients with tumor invasion in the portal vein trunk or first portal branches (Vp3) was carried out. 1) Efficacy of endoscopic treatment for varices : Variceal bleeding in emergent and elective cases was controlled in 91% of 19 patients with Vp3 portal invasion and in 94% of 38 patients without Vp3 portal invasion (N.S.). Re-bleeding was observed in 50% and 30% of these patients (N.S.), and death due to variceal bleeding occurred in 53% and 23% (p<0.05), respectively. Variceal bleeding in prophylactic cases was observed in 33% of 9 patients with Vp3 portal invasion and in 14.5% of 140 patients without Vp3 portal invasion (N.S.), and death caused by variceal bleeding was recorded in 22% and 3.3% (p<0.05), respectively. 2) Efficacy of prophylactic treatment for varices : Variceal bleeding in patients with Vp3 portal invasion was observed in 33% of 9 patients receiving prophylactic treatment and in 74% of 35 patients without prophylactic treatment (p < 0.05), and death due to variceal bleeding occurred in 22% and 49% (N.S.), respectively. Variceal bleeding in patients without Vp3 portal invasion was observed in 14% of 140 patients receiving prophylactic treatment and in 84% of 51 patients without prophylactic treatment (p < 0.001), and death due to variceal bleeding occurred in 3.3% and 27% (N.S.), respectively. We concluded that, 1) every effort should be made to avoid bleeding after endoscopic treatment because of the high incidence of variceal bleeding in patients with Vp3 portal invasion, 2) prophylactic treatment could decrease incidence of variceal bleeding in patients with Vp3 portal invasion, and could also decrease the incidence of variceal bleeding and of death due to bleeding in patients without Vp3 portal invasion.
- The Japan Society for Portal Hypertensionの論文
The Japan Society for Portal Hypertension | 論文
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