Endoscopic injection sclerotherapy improves liver function compared with endoscopic variceal ligation

Abstract

Liver function is a most important prognostic factor in patients with liver cirrhosis. Also, portal hypertension is a fatal complication of liver cirrhosis and variceal treatment is indispensable. However, changes of liver functions after endoscopic variceal treatments are unknown. The aim of this study was to evaluate prognosis and liver functions after endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL). A total of liver cirrhotic 103 patients who underwent prophylactic EIS and EVL were enrolled. Overall survival rate was higher in EIS group than EVL group (p = 0.03). Multivariate analysis showed that EIS was a negative factor for death (HR: 0.46, 95% confidence interval: 0.24–0.88, p = 0.02). Liver functions were assessed by blood test taken at before and 3 months after treatment. In EIS group, albumin and prothrombin time improved (p < 0.01), leading to improvement of Child–Pugh score, ALBI score and MELD score (p < 0.05). However, these did not improve in EVL group. EIS was a significant factor related to the elevated value of albumin after treatment in linear regression analysis (estimated regression coefficient: 0.17, 95% confidence interval: 0.05–0.29, p = 0.005). These results revealed that EIS could improve liver functions and prognosis.

Management of an Esophago-pleural Fistula after Emergent Endoscopic Variceal Injectional Sclerotherapy: A Case Report And Literature Review

“…EVB is one of the most feared complications of decompensated cirrhosis and requires urgent and effective treatment (5). EVIS has the advantages of direct vision, reliable haemostasis, and minimal invasion and is considered the first-line therapy for EVB (3). After entering the veins, the sclerosant destroys endothelial cells and causes inflamma- Although its usage has been largely replaced by endoscopic variceal ligation (EVL) due to the relatively higher risk of complications and a similar efficacy profile, EVIS remains a viable therapeutic option for certain patients with EVB, particularly at sites proficient in this treatment modality, such as our institution.…”

“…Over the past several decades, endoscopic variceal injectional sclerotherapy (EVIS) has gained wide popularity for the initial control of active esophageal variceal bleeding (EVB) (2). The technique of EVIS is achieved by injection of sclerosants to cause venous obturation and haemostasis, which has the advantages of a lower mortality and reduced incidence of hepatic encephalopathy compared with conventional portosystemic shunts (3).…”

Child–Pugh grade deterioration stratified by the etiology after transcatheter arterial chemoembolization as initial treatment for hepatocellular carcinoma

“…HCC has a high recurrence rate and liver functions tend to deteriorate with each repeated treatment 2 – 5 . Deterioration of liver functions can limit treatment options in HCC treatment strategy, leading to a poorer prognosis 6 , 7 . Therefore, tumor conditions and liver functions should be considered in selecting treatment methods when HCC occurs 8 , 9 .…”