COMPARISON OF PERCUTANEOUS TRANSHEPATIC PORTOGRAMS OBTAINED BEFORE AND AFTER ERADICATIVE ENDOSCOPIC VARICEAL LIGATION OF ESOPHAGEAL VARICES

Abstract

The patients underwent eradicative endoscopic ligation of untreated esophaeal varices employing 40 O-rings per case on the average. Eradicative endoscopic variceal ligation is the treatment of routine choice in our department as the alternative to sclerotherapy. The treatment-related change in hemodynamics in these patients was investigated by percutaneous transhepatic portgraphy (PTP). Pre-treatment PTP revealed images of the regions ranging from the left gastric vein (alone or together with the posterior gastric vein) hepatofugally via the cardiac venous plexus and Sudare like vein to the esophageal varices or paraesophageal vein. After the treatment, endoscopic findings in all cases turned to F₀, RC (-) and images of cardiac venous plexus decreased, and images of the Sudare like vein and the esophageal varices or paraesophageal vein were scarcely seen in PTP. Thus, the bloodstream from the portal vein not so much reached into the esophageal varices after the ligation, a hemodynamic change assuring the effectiveness of the treatment.