Prospective randomized trial of endoscopic sclerotherapy versus variceal band ligation for esophageal varices: influence on gastropathy, gastric varices and variceal recurrence

Sarin, Shiv Kumar; A, Govil; Jain, Ajay K.; Guptan, R. C.; Issar, Sanjeev Kumar; Jain, Monika; Murthy, N S

doi:10.1016/s0168-8278(97)80248-6

Cited by 207 publications

(137 citation statements)

References 18 publications

Supporting

Mentioning

114

Contrasting

Unclassified

Order By: Relevance

“…However, some of the unfavorable outcomes were significantly reported among the sclerotherapy than the EBL groups. The initial success to control bleeding for both techniques is compatible with the universally reported figures (around 90%) [20]. However, it was significantly higher in the EBL versus EIS groups (96.7% versus 84.5%; p 0.02).…”

Section: Discussionsupporting

confidence: 87%

Management of acute esophageal variceal bleeding by endoscopic sclerotherapy in technically difficult endoscopic band ligation cases—A population based cohort study

Esmat¹,

Hamza²,

Abbas³

et al. 2013

OJGas

View full text Add to dashboard Cite

Endoscopic band ligation is regarded as the main therapeutic option for acute esophageal variceal bleeding, while sclerotherapy may be used in the acute setting if ligation is technically difficult. The incidence of difficult-to-perform band ligation in acute esophageal variceal bleeding, as well as the outcome of patients subjected to injection sclerotherapy as an alternative treatment, has not been clearly investigated. Our aim is to study the outcome of patients subjected to injection sclerotherapy in the acute setting of esophageal variceal bleeding when endoscopic band ligation is technically difficult to perform. We included 151 patients with acute esophageal variceal bleeding originnating from medium or large sized varices. All patients were planned for EBL as the 1st treatment option (EBL group 61.6%), meanwhile, EIS using 5% ethanolamine oleate was reserved as the 2nd treatment option when EBL was technically difficult (EIS group 38.4%). The mean time to restore hemodynamic stability was significantly prolonged in the EIS group (11.5 ± 6.5 hrs versus 9.5 ± 5.0 hrs, p 0.05). Initial control of bleeding was significantly higher in the EBL group versus the EIS group (96.7% vs 84.5%, p 0.021). Re-bleeding was more among the EIS group (42.9% vs 24.2%, p 0.04). There were no significant differences as regarding mortality and duration of hospital stay. So, a considerable proportion of cases presenting with acute variceal bleeding will have difficulty in performing EBL. In these patients, sclerotherapy is not a waning procedure with an accepted success rate, without much additional complications and without deranging mortality.

show abstract

Section: Discussionsupporting

confidence: 87%

Management of acute esophageal variceal bleeding by endoscopic sclerotherapy in technically difficult endoscopic band ligation cases—A population based cohort study

Esmat¹,

Hamza²,

Abbas³

et al. 2013

OJGas

View full text Add to dashboard Cite

show abstract

“…Based on these findings, we believe that this specific patient profile represents the most suited group for indication of the procedure of transhepatic percutaneous embolization of the left gastric vein. We also hold the view that in previously operated patients with persistent and/or rechanneled left gastric vein, the chances of success following endoscopic treatment in the medium to long term are slim, mirroring results obtained after splenectomy alone, a technique known to be relatively ineffective and associated with hemorrhage recurrence rates of up to 54% (6,31) . Perhaps in a different scenario, armed with the appropriate knowledge of hepatofugal circulation of each case of hemorrhagic recurrence due to gastroesophagic varices, the transhepatic percutaneous procedure for embolization of the left gastric vein may have played a greater role in the management of these patients.…”

Section: Discussionmentioning

confidence: 73%

Trashepatic left gastric vein embolization in the treatment of recurrent hemorrhaging in patients with schistosomiasis previously submitted to non-derivative surgery

Saad

Razuk²,

Telles³

et al. 2012

Arq. Gastroenterol.

View full text Add to dashboard Cite

-Context -Non-derivative surgical techniques are the treatment of choice for the control of upper digestive tract hemorrhages after schistosomotic portal hypertension. However, recurrent hemorrhaging due to gastroesophagic varices is frequent. Objective -To evaluate the outcome of treatment based on embolization of the left gastric vein to control the reoccurrence of hemorrhages caused by gastroesophagic varices in patients with schistosomiasis previously submitted to non-derivative surgery. Methods -Rates of reoccurrence of hemorrhages and the qualitative and quantitative reduction of gastroesophagic varices in patients undergoing transhepatic embolization of the left gastric vein between December 1999 and January 2009 were studied based on medical charts and follow-up reports. Results -Seven patients with a mean age of 39.3 years underwent percutaneous transhepatic embolization of the left gastric vein. The mean time between azigoportal disconnections employed in combination with splenectomy and the percutaneous approach was 8.4 ± 7.3 years, and the number of episodes of digestive hemorrhaging ranged from 1 to 7 years. No episodes of reoccurrence of hemorrhaging were found during a follow-up period which ranged from 6 months to 7 years. Endoscopic postembolization studies revealed reductions in gastroesophagic varices in all patients compared to preembolization endoscopy. Conclusions -Percutaneous transhepatic embolization of the left gastric vein in patients with schistosomiasis previously submitted to surgery resulted in a decrease in gastroesophagic varices and was shown to be effective in controlling hemorrhage reoccurrence.

show abstract

“…51 Gastric varices are more common in NCPF than in cirrhosis and gastropathy developing after variceal obliteration is usually transitory and non-progressive in NCPF. 52 …”

Section: Investigationsmentioning

confidence: 99%

Noncirrhotic Portal Hypertension

Rajekar¹,

Vasishta²,

Chawla³

et al. 2011

Journal of Clinical and Experimental Hepatology

View full text Add to dashboard Cite

Portal hypertension is characterized by an increase in portal pressure (> 10 mmHg) and could be a result of cirrhosis of the liver or of noncirrhotic diseases. When portal hypertension occurs in the absence of liver cirrhosis, noncirrhotic portal hypertension (NCPH) must be considered. The prognosis of this disease is much better than that of cirrhosis. Noncirrhotic diseases are the common cause of portal hypertension in developing countries, especially in Asia. NCPH is a heterogeneous group of diseases that is due to intrahepatic or extrahepatic etiologies. In general, the lesions in NCPH are vascular in nature and can be classified based on the site of resistance to blood flow. In most cases, these disorders can be explained

show abstract

Prospective randomized trial of endoscopic sclerotherapy versus variceal band ligation for esophageal varices: influence on gastropathy, gastric varices and variceal recurrence

Cited by 207 publications

References 18 publications

Management of acute esophageal variceal bleeding by endoscopic sclerotherapy in technically difficult endoscopic band ligation cases—A population based cohort study

Management of acute esophageal variceal bleeding by endoscopic sclerotherapy in technically difficult endoscopic band ligation cases—A population based cohort study

Trashepatic left gastric vein embolization in the treatment of recurrent hemorrhaging in patients with schistosomiasis previously submitted to non-derivative surgery

Noncirrhotic Portal Hypertension

Contact Info

Product

Resources

About