ELECTIVE AND PROPHYLACTIC ENDOSCOPIC INJECTION SCLEROTHERAPY (EIS) FOR ESOPHAGEAL VARICES

It's Influence on Liver Function with Portographic and Prognostic Evaluation

Abstract

Elective and prophylactic EIS was performed in 67 cirrhotic patients with esophageal varices.
Portographic studies were made before and after EIS on the collateral hemodynamics of the portal system. Studies were also made on the liver function and on the cause of death after EIS. In 18 out of 34 cases, PVP was decreased in a few months after EIS and the reformation of collateral directional flow pattern was found in 13 cases of those 18. The rest of them showed increased PVP after EIS. However there was no influence of PVP changes on the liver function in both groups. It was suggested that EIS provoke the similar collateral changes as was reported by Idenzuki, who described same changes after transthoracic esophageal transection (Walker 1952). Studies on cause of death in 11 cases after EIS revealed that the association of hepatocellular carcinoma and/or portal thrombosis was an important factor in prognosis even though complete eradication of esophageal varices was accomplished by EIS.