Endoscopic Treatment for Esophageal Variceal Bleeding Associated with Concomitant Portal Trunk and/or Main Branch Invasion of Hepatocellular Carcinoma

概要

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We performed endoscopic injection sclerotherapy or endoscopic injection sclerotherapy with ligation in the treatment of 21 patients with esophageal variceal bleeding due to portal trunk and/ or main branch invasion of hepatocellular carcinoma (Vp3 HCC). Acute bleeding was controlled in 19 of 21 patients (90%), rebleeding occurred in 7 of 19 patients (37%), and only 4 patients died of variceal bleeding. Mean survival time was 91 ± 80 days (range, 3 to 232 days), and 8 patients with jaundice and/or uncontrollable ascites at the time of treatment died within 6 weeks, usually because of liver failure. The cumulative survival rate in the treated group was not significantly different from that in the patients who did not develop bleeding despite presenting with Vp3 HCC and red color sign positive esophageal varices. It is suggested that emergency endoscopic treat-ment, even in cases of Vp3 HCC, is effective for controlling esophageal variceal bleeding and can promote survival similar to that in the non-bleeding group.
The Japan Society for Portal Hypertensionの論文