Endoscopic injection sclerotherapy for esophageal varices associated with concomintant portal venous thrombus of hepatocellular carcinoma
✍ Scribed by Masayuki Ohta; Makoto Hashizume; Morimasa Tomikawa; Tatsuro Kamakura; Kouhei Akazawa; Kiichiro Ueno; Hirohiko Yamaga; Seigo Kitano; Kazuo Tanoue; Takashi Matsumata; Keizo Sugimachi
- Publisher
- John Wiley and Sons
- Year
- 2006
- Tongue
- English
- Weight
- 477 KB
- Volume
- 59
- Category
- Article
- ISSN
- 0022-4790
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✦ Synopsis
Between 1983 and 1994, we treated 51 patients with esophageal varices and portal trunk and main branch invasion of hepatocellular carcinoma, using endoscopic injection sclerotherapy . Variceal bleeding was controlled in 28 of 29 patients (96.6%), esophageal varices were completely eradicated in 28 (54.9%), and only 2 of 28 (7.1%) bled from small, dilated, venous vessels after eradication. The cumulative nonbleeding rate at 3 years was 87.5%. Death caused by hepatocellular carcinoma accounted for 89.4% of the patients, whereas the rate of bleeding from esophageal varices was 4.3%. Variables significantly associated with the duration of survival were Okuda's clinical stage, alpha-fetoprotein, eradication of esophageal varices by sclerotherapy , and treatment of hepatocellular carcinoma, as determined in a univariate analysis. Multivariate analysis showed that eradication of esophageal varices by sclerotherapy , Okuda's clinical stage, and age were independent factors which significantly influenced survival time. We propose that complete eradication of esophageal varices and close follow-up using endoscopy may lead to a reduction in bleeding from esophageal varices, and hence may reduce mortality rates related to this bleeding.