Abstract
Between 2003 and 2010, 25 patients with gastric fundal varices (GV) (n=15) or hepatic encephalopathy (n=10) received inter ventional radiologic embolotherapy in our hospital. Balloon-occluded retrograde transvenous obliteration (B-RTO) procedure was performed on 4 patients, percutaneous transhepatic obliteration (PTO) procedure or trans ileocolic vein obliteration (TIO) on 13 patients, and the combined B-RTO and PTO therapy, “double balloon occluded embolotherapy (DBOE)” on 8 patients. To treat GV, B-RTO was performed on 4 patients, PTO on 3 patients, TIO on one patient, and DBOE on 8 patients. After these treatments, all gastric varices disappeared or decreased in size. Recurrence of GV was found in 1 patient 21 months after the treatment. Enlarged esophageal varices were seen in 5 patients, however, these varices could be treated with endoscopic injectional sclerotherapy. The 1-and 5-year survival rates were 80% and 56%, respectively. In patients of hepatic encephalopathy, 2 were treated with B-RTO and 9 with PTO. Hepatic encephalopathy was partially or completely improved in all patients. Serum ammonia, prothrombin time and Child-Pugh score were improved significantly. The 1-and 5-year survival rates were 80% and 40%, respectively. These inter ventional treatments are safe and effective for patients with GV and hepatic encephalopathy.
