THE EFFECTIVENESS OF ENDOSCOPIC INJECTION SCLEROTHERAPY COMBINED WITH VASCULAR EMBOLIZATION ON ESOPHAGO-GASTRIC VARICES

WITH SPECIAL REFERENCE TO STUDY ON CASES OF INSUFFICIENT EFFECTS AND RECURRENCES

Abstract

We have experienced 66 cases of endoscopic injection sclerotherapy (EIS) for severe esophagogastric varices. And we evaluated the effectiveness of EIS combined method with vascular embolization with special reference to study on cases of insufficient effects and recurrences after EIS. A compared study between 34 patients receiving EIS alone (EIS group) and 32 patients treated by combined EIS and vascular embolization (combined Emb group) revealed more preventive rates of cumulative recurrence (P<0.05) in the combined Emb group. Interval duration from initial to supplemental treatment in the combined Emb group was approximantely twice as long as in the EIS group. Favorable results were especially obtained from the combined Emb group in cases of Child C. Recurrencies were frequent in the EIS gruop among Child C cases with markedly effective and effective treatment, and recurrences or bleeding occurred within 1 year. Insufficient effects were obtained from 83.3% in Child C cases also corresponding to more than 2 items of Child's classification and the majority, approximately 67%, included in patients treated with the EIS alone. Regarding the importance of reliable and permanent effects for the treatment of esophagogastric varices, this study suggested that combined endoscopic sclerotherapy and vascular embolization were extremely useful for the treatment in patients with severe hepatic functional impairment.