Abstract
Between 1983 and 1992, endoscopic injection sclerotherapy (EIS) using 5% ethanolamine oleate according to the so-called traditional method was performed in 170 patients with esophageal varices. In 1993, we adopted a new method, tentatively called the “waiting method”, in which additional EIS was withheld (“waiting”) until variceal inflammatory swelling caused by the former EIS disappeared. Between 1993 and 1998, the waiting method was employed in 48 patients. The disappearance rate of esophageal varices by EIS in cases of no hepatocellular carcinoma treated by the waiting method was 93.9% (traditional method; 65.3%) and the recurrent rate was only 2.9% (traditional method; 8.0%). Compared to the traditional method, the amount of sclerosant (35.6 ± 15.4 vs 53.2 ±26.4 ml; p <0.01), frequency of EIS (3.0 ± 1.1 vs 4.8 ±2.3; p < 0.001), duration of hospitalization (89.6 ±33.2 vs 118.0 ± 42.0 days; p <0.001), and complications (2.1 vs 28.2%; p <0.001) decreased in patients treated with the waiting method. We propose that because EIS employing the waiting method has numerous merits compared to conventional EIS, it should be regarded as the first choice of treatment for esophageal varices.
