Treatment of Oesophageal Varices

Terblanche, J.

doi:10.1177/014107687907200301

Cited by 5 publications

(4 citation statements)

References 28 publications

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“…Endoscopic sclerotherapy has been proven to be beneficial for the control of active variceal bleeding; it prevents rebleeding and improves the survival of the patients by eradicating the varices with repetitive sclerotherapeutic sessions [8,9,26]. A major problem with repetitive sclerotherapy is recurrent hemorrhage before the varices are completely obliterated.…”

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confidence: 99%

A prospective randomized controlled trial of sclerotherapy vs ligation in the prophylactic treatment of high-risk esophageal varices

et al. 1999

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A prospective randomized controlled trial of sclerotherapy vs ligation in the prophylactic treatment of high-risk esophageal varices

et al. 1999

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“…As it carries a 20% mortality rate in the first 6 weeks it is clear that the gauntlet is flung at the treating physicianeven more so in a rural setting where patients often present late and there are limited resources [1]. Stepwise management protocols guide management in the acute setting, with surgery being the last tier [3]. The introduction of endoscopic therapy has significantly decreased mortality from variceal bleeding [4].…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic banding is widely regarded as the standard of care for both acutely bleeding varices and long-term management followed by repeated injection sclerotherapy for long-term management after an acute bleed [5]. This is in conjunction with vasoactive drugs as medical management [3].…”

Section: Discussionmentioning

confidence: 99%

“…Complications include hepatic encephalopathy, oesophageal stricture, mediastinitis, pleural effusion, anastomotic leak and subdiaphragmatic collection [2,6,9]. Factors directly influencing morbidity are a higher Child score and the severity of the bleed [1,3,6]. Jenkins and Shields reviewed their experience of emergency oesophageal transection in 15 patients with variceal hemorrhage after failed injection sclerotherapy between 1980-1986 [8].…”

Section: Discussionmentioning

confidence: 99%

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Oesophageal Transection for Bleeding Varices: Case Report and Literature Review

Pienaar¹,

Čačala²,

Oosthuizen³

2021

JSCR

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Surgical oesophageal transection for uncontrolled variceal bleeding is a last resort measure that is rarely needed due to modern endoscopic advancements. Since it is infrequently required, most of the younger General Surgeons have not been exposed to this procedure. However, it remains a valuable consideration when endoscopic measures and balloon tamponade fail to control bleeding oesophageal varices and should remain in the armamentarium of the General Surgeon. Here we present a case of such a patient who underwent oesophageal transection as a life-saving procedure with satisfactory outcome, together with a brief literature review on this topic.

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Interventional Endoscopy

Taylor

1986

Modern Concepts in Gastroenterology

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We report our experience with self-expandable nitinol coil stents (InStent, Inc.) (range 0.5-20).Results: Using EBS alone, the bile duct was cleared in 70 patients (76%). Mechanical lithotripsy was used to remove large stones (15-20 mm) in 13 (15%). Of the 20 EBS "failures" (24%) papillotomy was required to clear the duct in 7 (9%). A pigtail stent was inserted in 13 (15%) to maintain biliary drainage a) as a temporary measure because of doubt about residual stones >15 mm (n = 7, 9%), or b) as a definitive measure in elderly high risk patients with multiple stones >15 mm (n = 6, 6.5%). ERCP was repeated in 14 (16%) for stent removal ± replacement or repeat EBS-duct clearance (n = 4). There was no papillary haemorrhage, while uncomplicated pancreatitis was observed in 4 patients (5%).Conclusion: EBS is a safe and effective sphincter preservation technique for the management of BD stones up to 20 mm in size, which significantly reduces the need for papillotomy.

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Treatment of Oesophageal Varices

Cited by 5 publications

References 28 publications

A prospective randomized controlled trial of sclerotherapy vs ligation in the prophylactic treatment of high-risk esophageal varices

A prospective randomized controlled trial of sclerotherapy vs ligation in the prophylactic treatment of high-risk esophageal varices

Oesophageal Transection for Bleeding Varices: Case Report and Literature Review

Interventional Endoscopy

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