Abstract
No treatment has been established for bleeding gastric fundal varices (FV), which are associated with a high mortality rate. We carried out a preliminary study to evaluate the short-term efficacy of prophylactic balloon endoscopic sclerotherapy for patients with high risk FV associated with gastrorenal shunt. Between May and November 1997, prophylactic balloon endoscopic sclerotherapy was performed in five cirrhotic patients judged as having high-risk FV. Variceal size was 14-21 mm (mean : 17.4 mm). The therapeutic effect of balloon endoscopic sclerotherapy on FV, complications, and patency of gastrorenal shunt were assessed. Blood flow in FV was well blocked with a balloon catheter inserted into gastrorenal shunt, and technical success was achieved in all patients after the procedure. FV disappeared in 3 patients or showed marked improvement in 2 patients. Subsequently FV did not recur. No local or systemic complications occurred and the gastrorenal shunt remained intact in all patients. No patient died or showed a change in Child-Pugh classification during the follow-up of period of 14-20 months (mean : 16.6 months). Development of esophageal varices did not occur in any patients. In conclusion, balloon endoscopic sclerotherapy may be useful because it is a safe and reliable treatment for high risk FV.
