The effect of endoscopic sclerotherapy of esophageal varices on the development of gastric varices.

BACKGROUND AND STUDY AIMS: The effect of sclerotherapy of esophageal varices on the development of gastric varices is a controversial question. The aim of the present study was to evaluate prospectively the presence and development of gastric varices as a consequence of esophageal variceal sclerotherapy. PATIENTS AND METHODS: We prospectively studied 227 patients, all of whom had liver cirrhosis at the time of the first bleeding episode due to esophageal varices. All patients were treated with emergency endoscopic sclerotherapy, and further courses of sclerotherapy to eradicate the varices were given at seven-day intervals for three sessions, and then every fifteen days until eradication was complete. At the time of inclusion in the study, patients were divided in two groups: group A, with initial gastric varices, and group B, without any gastric varices initially. RESULTS: Group A included 138 patients (60.8%), in 99 of whom (71.7%) disappearance of the gastric varices was observed. In 63 cases (63.6%) the varices were eliminated during the sclerotherapy treatment, before the eradication of esophageal varices; in 36 cases (36.4%), the gastric varices disappeared after the eradication of the esophageal varices. Group B included 89 patients (32.9%); in 78 of them (87.6%), no appearance of gastric varices was observed, while in 11 (12.4%), gastric varices appeared. CONCLUSION: From these data, it can be concluded that sclerotherapy of esophageal varices cannot be a determinant factor either for the appearance of gastric varices or for their subsequent risk of bleeding.