静脈瘤供血路と食道静脈瘤に対する内視鏡的結紮術後のportal hypertensive gastropathyの進展

抄録

Endoscopic variceal ligation（EVL）is one factor influencing the development of portal hypertensive gastropathy（PHG）. Though the pathogenesis of this condition has not been described, it is important to investigate the relationship between variceal inflow and PHG.
This study was conducted to determine how a modified method, eradicative EVL（eEVL）, which utlizes approximately 40 rings, affects portal hemodynamics and PHG. Thirty-seven cirrhotic patients were examined serologically, endoscopically and portographically before and 2 weeks after eEVL.
The development of PHG was observed in 15 of 37 patients（40.5％）after eEVL. These 15 patients had slightly higher Child-Pugh scores and a significantly（p＜0.05）larger number of variceal inflow vessels（left, posterior and/or short gastric veins）by percutaneous transhepatic portography before eEVL. A significant（p＜0.001）decrease in these vessels was revealed post-eEVL.
The development of PHG seems to be due to congestion of these vessels caused by the eradicative therapy for esophageal varices.