The Effectiveness of Endoscopic Interventions in Liver Cirrhosis Patients

Nazyrov, F. G.; Devyatov, A. V.; Бабаджанов, А. Х.; Dzhumaniyazov, D. A.; Baybekov, R. R.

doi:10.16931/1995-5464.2017245-53

Cited by 3 publications

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“…Кровотечение из варикозно расширенных вен пищевода (ВРВП) -грозное осложнение синдрома портальной гипертензии, являющееся одной из основных причин смерти у больных циррозом печени [1,2,3]. Летальность от первого кровотечения составляет 20-50%, а при рецидиве геморрагии достигает 70% [4,5].…”

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“…Эффективность данного способа эндоскопического гемостаза при остром кровотечении составляет 86-95% [3]. Частота рецидива ПЖК в раннем послеоперационном периоде 15-30% [1]. Летальность колеблется от 3,6 до 10,2% [3].…”

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“…В данном случае рекомендуют рассматривать возможность выполнения трансъюгулярного внутрипечёночного портосистемного шунтирования (TIPS -от англ. transjugular intrahepatic portosystemic shunt) [1,2].…”

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Prevention of recurrent bleeding from varicose veins of the esophagus and stomach among patients with decompensated liver cirrhosis

et al. 2019

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Aim. To evaluate the efficiency of laparoscopic devascularization of the esophagus and stomach with endoscopic ligation of varicose esophageal veins in the prevention of esophageal-gastric bleeding among patients with decompensated liver cirrhosis. Methods. The results of treatment of 73 patients with decompensated liver cirrhosis and high risk of bleeding were analyzed. To prevent recurrent bleeding from esophageal and gastric veins, all patients underwent endoscopic ligation at the first step of treatment. In case of inefficiency of ligation and recurrence of varicose veins of esophagus, laparoscopic devascularization of esophagus and stomach was performed. The efficiency of laparoscopic devascularization with intraoperative endoscopic ligation of varicose esophageal veins and ligation as an independent method of treatment for the prevention of upper gastrointestinal bleeding was estimated by comparison of the frequency of recurrence of esophageal and gastric bleeding and recurrence of esophageal varices according to upper endoscopy in comparison groups. Results. In 6 months, 1 and 2 years after laparoscopic devascularization of the esophagus and stomach in combination with endoscopic ligation, the risk of bleeding is less compared to endoscopic ligation as an isolated treatment method (p=0.05; p=0.052; p=0.06). Laparoscopic devascularization with ligation reduces the risk of recurrence of esophageal varices during the first year after surgery by 20% (χ2=2.61; p=0.106), in 2 years by 23% (χ2=1.75; p=0.091) compared to endoscopic ligation only. Conclusion. Patients with liver cirrhosis with decompensated hepatic failure satisfactorily postpone endovideosurgical interventions; laparoscopic gastric devascularization with the intersection of the main inflows to the esophageal varicose veins is an effective method to prevent esophageal-gastric hemorrhage among patients with decompensated liver cirrhosis after ineffective endoscopic ligation.

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Prevention of recurrent bleeding from varicose veins of the esophagus and stomach among patients with decompensated liver cirrhosis

et al. 2019

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Intravasal foam sclerotherapy of esophageal varices as a new method of endoscopic bleeding prevention

Семичев¹,

Berdnikova²,

Nagovitsina³

2022

Endosk. khir.

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Endoscopic Prophylaxis and Treatment of Portal-Genesis Oesophageal Haemorrhage

Bebezov

Sultangaziev

Abdykadyrov

2022

Kreativnaâ hirurgiâ i onkologiâ

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Background. Portal hypertension-triggered oesophageal and gastric variceal bleeding is the most dangerous and threatening complication, with an up to 50–70 % mortality at first episode. High-mortality repeated bleeding develops subsequently in 30–50 % patients, with the proved 100 % recurrence rate in the first two years following the first episode. The world experience dictates further research to continue towards developing new surgical methods and approaches.Aim: to evaluate the treatment efficacy of pneumatic endoscopic band ligation of bleeding oesophageal varices (OV).Materials and methods. The experience of applying pneumatic endoscopic ligation treatment in the patients managed at the General Surgery Unit of the Clinical Hospital of the Kyrgyz Republic Presidential Administration during 2017–2019 was analysed. Endoscopic ligation is a modern minimally invasive and less traumatic intervention used to markedly reduce mortality and improve quality of life in patients with portal hypertension syndrome. The evidence on 76 patients following endoscopic OV ligation was summarised. The patient age ranged from 11 to 70 years (mean 46.26 years); 40 men (52.6 %) and 36 women (47.4 %) were included. Among the 76 patients, portal hypertension was caused by viral cirrhosis in 38, hepatitis B in 5, delta agent hepatitis B in 18, hepatitis C in 13, a hepatitis B–C combination in 1 and a delta agent hepatitis B — hepatitis C combination in 1 patient. In 21 patients, cirrhosis was of unknown aetiology. A portal vein malformation was observed in 13 people of whom 4 had it combined with thrombosis.Results. A total of 94 ligation procedures were performed in 76 patients with grade II–III OV. Some patients needed to undergo the procedure several times, 18 patients had 2 sessions. Two cases required 3 and 4 sessions each. Moderate oesophageal soreness was reported in 32 patients for 1–6 days following the ligation. No complications were registered during the operation. In early postoperative period, 2 patients developed recurrent bleeding, with haemostasis re-achieved by a repeated vein ligation below bleeding.Conclusion. Hence, small invasiveness and minor traumatism coupled with high efficiency and lesser complications render endoscopic ligation the method of choice in primary and secondary prophylaxis and treatment of OV. Endoscopic ligation improves the patient’s quality of life, allows an extra time for conservative treatment and longer period to liver transplantation.

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The Effectiveness of Endoscopic Interventions in Liver Cirrhosis Patients

Cited by 3 publications

References 0 publications

Prevention of recurrent bleeding from varicose veins of the esophagus and stomach among patients with decompensated liver cirrhosis

Prevention of recurrent bleeding from varicose veins of the esophagus and stomach among patients with decompensated liver cirrhosis

Intravasal foam sclerotherapy of esophageal varices as a new method of endoscopic bleeding prevention

Endoscopic Prophylaxis and Treatment of Portal-Genesis Oesophageal Haemorrhage

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