2024 Volume 30 Issue 1 Pages 36-43
Background: Treatment such as balloon-occluded retrograde rransvenous obliteration (BRTO) and percutaneous transhepatic obliteration (PTO) have been performed for conditions like esophageal varices and hepatic encephalopathy. We have empirically conducted these procedures only in patients with Child-Pugh (CP) class C cirrhosis up to 12 points. The outcomes and tolerability of these interventions were retrospectively investigated.
Methods: Nineteen patients with CP class C cirrhosis up to 12 points, undergoing a total of 22 BRTO and/or PTO procedures from 2007 to 2021, were included in the study. We compared the pre-treatment and 2-3 months post-treatment liver function, assessed long-term survival as a measure of effectiveness, and evaluated tolerability based on postoperative hospital stay and complications.
Results: Gastric varices disappeared in all patients after treatment, and hepatic encephalopathy improved in 94.1% of patients. Significant improvements were observed in liver function indicators such as CP score. The 1-year and 2-year survival rates were 77.2% and 50.0%, respectively, with a median survival of 784 days. Some patients experienced increased ascites postoperatively, but the average postoperative hospital stay was 21.5 days.
Conclusions: Even in patients with Child-Pugh class C cirrhosis, interventions like BRTO and PTO can be performed if the score is up to 12 points; however, careful perioperative management is essential thereafter.
