Pulmonary Functions after Injection Sclerotherapy of Esophageal Varices and after Band Ligation

Abstract

Aim of the study: To study changes in pulmonary function tests after esophageal variceal injection sclerotherapy in comparison to changes after esophageal variceal band ligation. Patients & methods:This study was designed as non randomized controlled study. Thirty patients with hepatic cirrhosis & portal hypertension who were admitted to Hepatology, Gastroenterology and Infectious Diseases department , Benha university hospital for elective esophageal variceal therapy (secondary prophylaxis) were classified into group I:15 patients treated with sclerotherapy by using 5-15 ml ethanolamine oleate and group II:15 patients treated with band ligation. Patients were subjected for full clinical evaluation including history, general, chest, and abdominal examination. Laboratory and radiological investigation including complete blood count, liver function tests, kidney function tests and blood sugar and plain chest x-ray (P.A. and lateral views) were done. Pulmonary function tests and arterial blood gasses were done before, one day after and one week after the procedure. Results:The results revealed , significant decrease in vital capacity in group I one day after injection ( p ˂ 0.05),but no significant decrease in vital capacity in group II. There was a significant decrease in PaO2 in group I one day after injection sclerotherapy ( p ˂ 0.05) but no significant changes in group II and no significant changes in PaCO2 in both groups one day after the procedures. The study has also revealed no significant changes in FVC,FEV1/FVC and PaCO2 in group I and group II after procedures. The study revealed significant linear correlation between the decreases in PaO2 and the percentage decrease in vital capacity( p ˂ 0.05). One week after procedure, pulmonary functions that has been affected in group I returned back to baseline values. Conclusions: esophageal injection sclerotherapy produces restrictive defect (decrease in PaO2 and vital capacity) in pulmonary functions one day after injection and improved within one week, while there was no effect for band ligation on pulmonary functions tests.