[Transcatheter embolization therapy of esophageal varices and hypersplenism with liver cirrhosis].

Transcatheter variceal embolization (PTO, TIO) has been performed in 71 cases and splenic artery embolization (SAE) in 22 cases (15 PTO-SAE combination and 7 SAE alone). Results for varices of PTO combined with SAE were better than with PTO alone. Furthermore PTO combined with SAE was found to be reliable even for long term control of bleeding, the longest follow up being almost over 3 years during which time we have had no case of rebleeding. Improvement of Child's criteria was seen to be better in SAE cases (52.4%) than in splenectomized cases (12.5%) and PTO alone (17.4%). Hepaplastin test and level of cholinesterase were used to assess liver function, before and after treatment. It was found that SAE cases improved considerably, in contrast to the splenectomized and control cases which showed little or no improvement. Thus to increase durability for long term control of bleeding and general condition, PTO should be combined with SAE. Furthermore, it is suggested that this combined embolization therapy should be used for nonsurgical treatment of esophageal varices and hypersplenism with liver cirrhosis.