Abstract
Endoscopic variceal ligation (EVL) combined with partial splenic embolization (PSE) was performed in 35 cases of esophageal varices, from Janu.ary 1994 to December 1997. Analysis was carried out on the cumulative recurrence rates of ‘ EVL combined with PSE’ on 31 cases where comLplete eradication of varices was achieved (F0 and negative Red colorsign) . We compared these rates to those of ‘ EVL only’ . The 6-month, ryear, and 2-yearrecurrence rates of ‘ EVL combined with PSE’ group were 21.1%, 37.2% and 58.1%, respectively. On the other hand, the 6-month, 1-year, and 2-year recurrence rates of ‘ EVL only’ group were 58.1%, 70.7%, and 80.4%, respectively. For all 3 time periods, recurrencerate of ‘ EVL combined with PSE’ group was significantly lower than that of ‘ EVL only’ group (log rank test, P=0.042) . Further analysis was made on the comparative recurrencerates of the two groups according to Child's classification. In Child A, the curnu.lativerecurrence rate of the ‘ EVL combined with PSE’ group was not significantly lower thanthat of ‘ EV:L only’ group. However, in Child B, the cumulative recurrence rate of ‘ EVLcombined with PSE’ group was significantly lower than that of ‘ EVL only’ group (log ranktest, P=0.032) . Lastly, in Child C, the same tendency as in Child B was seen between thesetwo groups. We conclude that ‘ EVL combined with PSE’ is a very effective therapy forachieving long term complete eradication of varices.
