G H Lo1, K H Lai, J S Cheng, R L Huang, S J Wang, H T Chiang. 1. Division of Gastroenterology, Department of Medicine, Veterans General Hospital, Kaohsiung, National Yang-Ming University, Taipei, Taiwan, Republic of China.
Abstract
BACKGROUND: The impact of banding ligation and injection sclerotherapy on paraesophageal varices and gastric varices has received scarce attention. We conducted a study using endoscopic ultrasound (EUS) to visualize paraesophageal varices and gastric varices in patients who underwent sclerotherapy and banding ligation. METHODS:Patients with esophageal variceal bleeding whose varices were obliterated by ligation (44 patients) and by sclerotherapy (35 patients) were enrolled. EUS was used to compare the prevalences of paraesophageal varices and gastric varices between the treatment groups. The correlation between paraesophageal varices and esophageal variceal recurrence and recurrent bleeding was assessed. RESULTS: The prevalence of paraesophageal varices was 86% in the ligation group compared with 51% in the sclerotherapy group (p = 0.002). The prevalence of gastric varices was slightly higher in the ligation group than in the sclerotherapy group (43% vs. 26%, p = 0.18). Esophageal varices recurred in 70% of the ligation group and 43% of the sclerotherapy group (p = 0.04). Patients in both groups with more severe paraesophageal varices had a significantly higher rate of variceal recurrence (p = 0.002 in ligation group and p = 0.001 in sclerotherapy group). Bleeding recurred in 6 patients in the ligation group and 4 patients in the sclerotherapy group. All patients with recurrent bleeding had paraesophageal varices. The rate of recurrent bleeding was significantly higher in patients with paraesophageal varices (p < 0.0001). CONCLUSIONS:EUS was helpful in the imaging of paraesophageal and gastric varices after sclerotherapy or banding ligation. Paraesophageal varices were more frequently noted in patients undergoing ligation. The presence of paraesophageal varices may predict the recurrence of esophageal varices and recurrent bleeding.
RCT Entities:
BACKGROUND: The impact of banding ligation and injection sclerotherapy on paraesophageal varices and gastric varices has received scarce attention. We conducted a study using endoscopic ultrasound (EUS) to visualize paraesophageal varices and gastric varices in patients who underwent sclerotherapy and banding ligation. METHODS:Patients with esophageal variceal bleeding whose varices were obliterated by ligation (44 patients) and by sclerotherapy (35 patients) were enrolled. EUS was used to compare the prevalences of paraesophageal varices and gastric varices between the treatment groups. The correlation between paraesophageal varices and esophageal variceal recurrence and recurrent bleeding was assessed. RESULTS: The prevalence of paraesophageal varices was 86% in the ligation group compared with 51% in the sclerotherapy group (p = 0.002). The prevalence of gastric varices was slightly higher in the ligation group than in the sclerotherapy group (43% vs. 26%, p = 0.18). Esophageal varices recurred in 70% of the ligation group and 43% of the sclerotherapy group (p = 0.04). Patients in both groups with more severe paraesophageal varices had a significantly higher rate of variceal recurrence (p = 0.002 in ligation group and p = 0.001 in sclerotherapy group). Bleeding recurred in 6 patients in the ligation group and 4 patients in the sclerotherapy group. All patients with recurrent bleeding had paraesophageal varices. The rate of recurrent bleeding was significantly higher in patients with paraesophageal varices (p < 0.0001). CONCLUSIONS: EUS was helpful in the imaging of paraesophageal and gastric varices after sclerotherapy or banding ligation. Paraesophageal varices were more frequently noted in patients undergoing ligation. The presence of paraesophageal varices may predict the recurrence of esophageal varices and recurrent bleeding.
Authors: Chun Qing Zhang; Fu Li Liu; Bo Liang; Zi Qin Sun; Hong Wei Xu; Lin Xu; Kai Feng; Zun Chang Liu Journal: Dig Dis Sci Date: 2007-11-21 Impact factor: 3.199
Authors: Ki Tae Suk; Soon Koo Baik; Jung Hwan Yoon; Jae Youn Cheong; Yong Han Paik; Chang Hyeong Lee; Young Seok Kim; Jin Woo Lee; Dong Joon Kim; Sung Won Cho; Seong Gyu Hwang; Joo Hyun Sohn; Moon Young Kim; Young Bae Kim; Jae Geun Kim; Yong Kyun Cho; Moon Seok Choi; Hyung Joon Kim; Hyun Woong Lee; Seung Up Kim; Ja Kyung Kim; Jin Young Choi; Dae Won Jun; Won Young Tak; Byung Seok Lee; Byoung Kuk Jang; Woo Jin Chung; Hong Soo Kim; Jae Young Jang; Soung Won Jeong; Sang Gyune Kim; Oh Sang Kwon; Young Kul Jung; Won Hyeok Choe; June Sung Lee; In Hee Kim; Jae Jun Shim; Gab Jin Cheon; Si Hyun Bae; Yeon Seok Seo; Dae Hee Choi; Se Jin Jang Journal: Korean J Hepatol Date: 2012-03-22