Efficacy of percutaneous transhepatic variceal embolization in treating esophageal and gastric variceal bleeding after esophageal-gastric devascularization with splenectomy / 中华消化杂志

ABSTRACT

Objective To assess the efficacy of percutaneous transhepatie variceal embolization (PTVE) in treating esophageal and gastric variceal bleeding after esophageal-gastric devascularization with splenectomy in patients with liver cirrhosis. Methods Twenty-two patients, who had history of esophageal-gastric devascularization with splenectomy, were either underwent PTVE with TH glue (n=10) or endoscopic injection of sclerosis (EIS, n = 12) for treatment of esophageal or gastric variceal rebleeding between Nov. 2006 and Sep. 2008. The patients were followed-up for recurrent bleeding, mortality, grade of esophageal and gastric varices and liver function. Portal vein pressure was measured before and after collateral embolization in PTVE group. Results ① The patients were followed-up for 12.5 months in PTVE group and 13.4 months in EIS group. There was significant difference (P<0.05) between PTVE and EIS groups in rebleeding rate (1/10 vs 7/12) and mortality (0 vs 3/12). ② The degree of esophageal and gastric varices after embolization or EIS was improved significantly. ③ For patients with portal vein thrombosis, combination of PTVE with portal vein balloon plasty could markedly improve portal vein blood supply. ④ Neither PTVE nor EIS aggravated the liver cirrhosis. Conclusion Compared with EIS, PTVE with TH glue may be a more effiective method in the treatment of rebleeding of patients with liver cirrhosis who had accepted esophagealgastric devascularization with splenectomy.