Combined endoscopic clipping and injection sclerotherapy for esophageal varices

Urita, Yoshihisa; Kondo, Eisaku; Muto, Masue; Yamada, Shoya; Hachiya, Akihiko; Ishihara, Manabu; Ozaki, Motonobu; Nishino, Mamoru; Naruki, Yukihiko; Otsuka, Sachio

doi:10.1016/s0016-5107(06)80117-3

Cited by 11 publications

(2 citation statements)

References 16 publications

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“…28 Endoscopic clipping to control haemorrhage, popular in Japan, has been combined with ES for oesophageal varices, 29 but has a limited role. Antibiotic prophylaxis is therefore recommended in patients with ascites receiving emergency endoscopic treatment for variceal bleeding.…”

Section: Sclerotherapymentioning

confidence: 99%

“…Antibiotic prophylaxis is therefore recommended in patients with ascites receiving emergency endoscopic treatment for variceal bleeding. 28 Endoscopic clipping to control haemorrhage, popular in Japan, has been combined with ES for oesophageal varices, 29 but has a limited role. 30 Recurrence of oesophageal varices after obliteration with STD has been reported in 14% of patients with reobliteration possible in half this group; complications including oesophageal ulcer (25%) and stricture formation (6%) are more common with absolute alcohol injection.…”

Section: Sclerotherapymentioning

confidence: 99%

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Oesophagogastric variceal bleeding in portal hypertension

Branicki

2000

Annals of the College of Surgeons of Hong Kong

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This article reviews substantial progress made in the past decade in the management of patients with portal hypertension who present with major upper gastrointestinal bleeding. Variceal and portal pressure measurements and endoscopy facilitate a reasoned approach to management, and several treatment options are available to gain control of ongoing or recurrent haemorrhage. These encompass endoscopic therapy (sclerotherapy, endoscopic variceal ligation), radiological intervention with transjugular intrahepatic systemic shunt (TIPS) procedures, and a variety of surgical procedures for devascularization or shunting from the highpressure portal system to low-pressure systemic venous connections. In most prospective randomized trials endoscopic variceal ligation has proved superior to sclerotherapy, and TIPS has found a role in the salvage of patients with further haemorrhage, sparing them surgical intervention. Advances in pharmacotherapy for the control of initial bleeding and secondary prophylaxis hold promise. Liver transplantation has become an option for selected patients with end-stage liver disease.Portal hypertension results from increases in portal blood flow and portal vascular resistance, bleeding from oesophageal varices being its most catastrophic complication. Mortality per bleeding episode is 30-50%, among survivors 60% will rebleed and 30% will die in the following year. 1 Varices result from an increase in portal pressure and factors which predict the risk of variceal haemorrhage include alcohol use, poor liver function, large varices and red wale markings on varices at endoscopy. 2,3 There is no correlation between spleen size and size of oesophageal varices. 4 Varices enlarge in 10-20% of patients within 1-2 years of their detection. 1 Why bleeding occurs unpredictably in individual patients is not known, but

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Section: Sclerotherapymentioning

confidence: 99%

Section: Sclerotherapymentioning

confidence: 99%