M K Goenka1, Usha Goenka2, I K Tiwary3, Vijay Rai3. 1. Institute of Gastrosciences, Apollo Gleneagles Hospitals, Kolkata, 700 054, India. mkgkolkata@gmail.com. 2. Department of Clinical Imaging and Interventional Radiology, Apollo Gleneagles Hospitals, Kolkata, 700 054, India. 3. Institute of Gastrosciences, Apollo Gleneagles Hospitals, Kolkata, 700 054, India.
Abstract
BACKGROUND/AIM: Patients with variceal band ligation (VBL)-induced ulcer bleeding and those with persisting bleeding in spite of VBL carry a high mortality. Balloon tamponade and transjugular intrahepatic portosystemic shunt have limitations in terms of complications, cost, and availability. The aim was to evaluate the efficacy of Sx-Ella Danis stent in persistent or complicated variceal bleeding. METHODS: Twelve patients with either persistent variceal bleeding or VBL-induced ulcer bleeding were treated with the placement of Sx-Ella Danis stents. The patients were followed up for mortality, complications, and efficacy to control bleeding. RESULTS: Stents were inserted successfully in all 12 patients (with immediate hemostasis). There was an immediate cessation of bleeding in all 12 patients with no stent-related complication. Five out of 12 patients died during 30 days post-procedure due to worsening encephalopathy or sepsis. Enteral feeding could be started in all 12 patients 6 h after stent placement. One patient had bleeding 10 days after stent removal and was re-stented but expired 7 days later. Stents were removed in eight patients at a mean duration of 17.5 days. (range 7 to 30 days). CONCLUSIONS: Sx-Ella Danis stent is a useful modality to control persistent variceal bleeding as well VBL-related ulcer bleeding.
BACKGROUND/AIM: Patients with variceal band ligation (VBL)-induced ulcer bleeding and those with persisting bleeding in spite of VBL carry a high mortality. Balloon tamponade and transjugular intrahepatic portosystemic shunt have limitations in terms of complications, cost, and availability. The aim was to evaluate the efficacy of Sx-Ella Danis stent in persistent or complicated variceal bleeding. METHODS: Twelve patients with either persistent variceal bleeding or VBL-induced ulcer bleeding were treated with the placement of Sx-Ella Danis stents. The patients were followed up for mortality, complications, and efficacy to control bleeding. RESULTS: Stents were inserted successfully in all 12 patients (with immediate hemostasis). There was an immediate cessation of bleeding in all 12 patients with no stent-related complication. Five out of 12 patients died during 30 days post-procedure due to worsening encephalopathy or sepsis. Enteral feeding could be started in all 12 patients 6 h after stent placement. One patient had bleeding 10 days after stent removal and was re-stented but expired 7 days later. Stents were removed in eight patients at a mean duration of 17.5 days. (range 7 to 30 days). CONCLUSIONS: Sx-Ella Danis stent is a useful modality to control persistent variceal bleeding as well VBL-related ulcer bleeding.
Entities:
Keywords:
Esophageal and gastric varices; Gastrointestinal hemorrhage; Portal hypertension; Self expanding metal stents; Variceal bleeding
Authors: R Hubmann; G Bodlaj; M Czompo; L Benkö; P Pichler; S Al-Kathib; P Kiblböck; A Shamyieh; G Biesenbach Journal: Endoscopy Date: 2006-09 Impact factor: 10.093
Authors: R Jalan; T G John; D N Redhead; O J Garden; K J Simpson; N D Finlayson; P C Hayes Journal: Am J Gastroenterol Date: 1995-11 Impact factor: 10.864