Abstract
Survival was evalvated based on factors affecting the prognosis after EIS was performad for esophageal varices.
EIS was performed in 69 cases between January, 1989 and September, 1993. There were 48 male and 21 female patients with a mean age of 57 years. There were 64 cases of liver cirrhosis, including 20 cases of hepatocellular carcinoma (HCC), 3 primary biliary cirrhosis cases and 2 other cases.
Child classification, timing of treatment, presence of HCC, bleeding after EIS, and recurrent varices were evaluated as factors affecting the prognosis of EIS using cumulative survival probability.
The primary factor affecting the prognosis was Child the classifieation C. Second was HCC, third emergency status and fourth bleeding after EIS. The prognosis was worst in cases that overlapped Child C with HCC or emergency. In elective cases, bleeding could be stopped conservatively. There was no difference between the prophylactic cases and elective cases in prognosis. Therefore we concluded that EIS should be performed in bleeding cases after improving the patient's general condition because those with bleeding after EIS had a worse prognosis than those with recurrent varices, Additional EIS should be performed to prevent bleeding. Survival was less than 2 years in emergent cases, HCC cases with VP 3 or H3, or in Child C cases showing bleeding after EIS. The survival duration was within 3 years in cases showing 2 mg/dl or more of T-bilirubin, less 3 g/dl of albumin, or uncontrollable ascites. It was concluded that prophylactic and/or additional EIS might be indicated in patients with high varices before the appearance of HCC with VP 3 or H 3 or progression to Child C classification.
