Abstract
Thirty three patients who showed recurrent or aggravated esophageal varices after combined endoscopic variceal ligation (EVL) and endoscopic injection screlotherapy (EIS) using 1% polidocanol under went additional therapy. As additional therapy, four were treated with the combination therapy again, and remaining 29 were treated with the EIS. Of the 33 patients, 16 were found to have residual varices, and 17 were found to have F0RC (-) varices in the lower esophagus by endoscopy performed one month after the initial therapy. Patients with F0RC (-) varices were treated on an outpatinet basis, and the additional therapy was started when RC sign was found positive or varices were found aggravated. The culmulative recurrence-free survival rate after the additional therapy was 64.7% in patients with residual varices (during 4 year follow-up) and 64.2% in patients with F0RC (-) varices (during 2 year follow-up). Although recurrence rate after the combined therapy was thus high, bleeding from esophageal varices was prevented when the additional therapy was performed as early as recurrence of varices were observed. These observations indicate that additional combined EVL and EIS was effective for recurrent esophageal varices when performed during early period of recurrence.
