2000 Volume 57 Issue 2 Pages 30-33
The endoscopic ligation therapy for esophageal varices is now widely accepted, and is thought to be less effective on the variceal inflow vessels than other procedures. We have applied eradicative endoscopic variceal ligation (eEVL) to esophageal varices to make up for this disadvantage. We used color-Doppler endoscopic ultra-sonography (CDEUS) to measure the blood flow of the left gastric vein (LGV) . Ten patients, who were not treated previously, were enrolled in this study, and underwent eEVL which involves the application of approximately 40 O-rings for each patient. The LGV flow was measured by ultrasonographic system (EUB 525, HITACHI) and fiberscopic system (FG36UX, PENTAX) before and after eEVL to ligate not only the varices but also the esophago-gastric junction and the intervariceal regions. We measured the diameter, the direction, the velocity and the flow volume of LGV and its anterior and posterior branches. As the result of our investigation, the blood flow of the LGV either decreased or was not detected. And in other cases, the hepatofugal blood flow of post erior branch of LGV continued after therapy. Thus eEVL is an effective theraputic procedure for reducing the blood flow to esophageal varices.
