BACKGROUND: Among the factors influencing variceal relapse after endoscopic treatment, portal hemodynamic changes, especially in portal systemic shunts, could be the most important factor because hemodynamics are directly related to the development of esophageal varices. We aimed to clarify the influence of endoscopic treatment for esophageal varices on portal systemic shunts as well as its predictive value for variceal relapse. METHODS: Fifty patients who underwent combined endoscopic variceal ligation and injection sclerotherapy were examined with sonography and portography. RESULTS: Decrease of diameter, hepatopetal flow direction in the left gastric vein, or the presence of non-varices portal systemic shunt were sonographic findings related to a low incidence of variceal relapse. The presence of blood flow in and around the esophagus on venograms was highly predictive for variceal relapse. In patients with such venograms, non-varices portal systemic shunts did not develop. CONCLUSIONS: Sonographic assessment of hemodynamic changes in portal systemic shunt could be useful for estimating the results of endoscopic treatment for esophageal varices.
BACKGROUND: Among the factors influencing variceal relapse after endoscopic treatment, portal hemodynamic changes, especially in portal systemic shunts, could be the most important factor because hemodynamics are directly related to the development of esophageal varices. We aimed to clarify the influence of endoscopic treatment for esophageal varices on portal systemic shunts as well as its predictive value for variceal relapse. METHODS: Fifty patients who underwent combined endoscopic variceal ligation and injection sclerotherapy were examined with sonography and portography. RESULTS: Decrease of diameter, hepatopetal flow direction in the left gastric vein, or the presence of non-varices portal systemic shunt were sonographic findings related to a low incidence of variceal relapse. The presence of blood flow in and around the esophagus on venograms was highly predictive for variceal relapse. In patients with such venograms, non-varices portal systemic shunts did not develop. CONCLUSIONS: Sonographic assessment of hemodynamic changes in portal systemic shunt could be useful for estimating the results of endoscopic treatment for esophageal varices.
Authors: H Mizumoto; S Matsutani; T Fukuzawa; H Ishii; G Sato; H Maruyama; H Saisho Journal: J Gastroenterol Hepatol Date: 2001-05 Impact factor: 4.029
Authors: A Matsumoto; N Hamamoto; A Ohnishi; H Miyoshi; K Sugi; H Kojima; M Kayazawa; H Morikawa; I Hirata; K Katsu Journal: Gastrointest Endosc Date: 1999-12 Impact factor: 9.427
Authors: S Hino; H Kakutani; K Ikeda; H Yasue; Y Kitamura; K Sumiyama; Y Uchiyama; A Kuramochi; K Matsuda; H Arakawa; K Hachiya; M Kawamura; K Masuda; H Suzuki Journal: Endoscopy Date: 2001-10 Impact factor: 10.093
Authors: T Suzuki; S Matsutani; K Umebara; G Sato; H Maruyama; O Mitsuhashi; Y Nakano; T Fukamachi; H Saisho Journal: Gastrointest Endosc Date: 2000-11 Impact factor: 9.427