[Evaluation of 2 years' experience with elective endoscopic sclerotherapy of hemorrhagic esophageal varices in cirrhotic patients].
The authors report their 2-year experience of esophageal endoscopic sclerotherapy for prevention of recurrent variceal bleeding in patients with liver cirrhosis. Sixty-three alcoholic cirrhotics underwent sclerotherapy 10 +/- 6 days (SD) after hospital admission for variceal bleeding. Varices were successfully eradicated in 43 patients (68 p. 100), with an average of 3 injection sessions, over a mean period of 5 weeks. Unsuccessful treatment was due to abbreviated course of treatment because of early rebleeding and early mortality. Early rebleeding episodes after therapy occurred in 19 patients (30 p. 100): 10 in whom the esophageal varices were eradicated, 9 in whom sclerotherapy had failed. Recurrent hemorrhage was the cause of death in 6 patients. After variceal eradication had been achieved, new varices were observed in 7 p. 100 of patients after a mean follow-up of 8 months. The risk of further variceal bleeding was 0.008 hemorrhage/patient/month. Minor complications (thoracic pain, dysphagia, esophageal ulcers, pleural effusion) occurred in 60 p. 100 of patients. An esophageal stricture developed in 13 out of the 43 successfully treated patients (30 p. 100). Major complications occurred in 5 patients and was the cause of death in 4: mediastinitis, esophageal perforation, bronchoesophageal fistulae, cardiogenic shock and aspiration pneumonitis. The survival curve, assessed by cumulative life analysis, showed a 60 p. 100 survival rate after 12 months and 56 p. 100 after 18 months. It was significantly different (p less than 0.001) between groups of cirrhosis classified according to Child-Pugh's criteria (95, 52 and 9 p. 100 at 12 months for groups A, B and C respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000517:prevention & control / Q000628:therapy*; D004945:Esophagoscopy; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012597:Sclerosing Solutions / Q000627:therapeutic use*
D012597:Sclerosing Solutions
Bilan de deux années d'expérience de la sclérothérapie endoscopique élective des varices oesophagiennes hémorragiques chez le cirrhotique.