Effects on liver functions of gastric variceal therapy by endoscopic ligation using a detachable snare and sclerotherapy with O-ring ligation.
Although various effects of therapy for gastric varices, a complication of portal hypertension, on portal hemodynamics have been suggested, the effects of the therapy on liver functions have not yet been clarified. The aim of this study was to examine the effects of endoscopic gastric variceal therapy on liver functions in patients with hepatic cirrhosis. The subjects were 18 hepatic cirrhosis patients with the complication of gastric varices, who could be monitored for a long term (at least 1-year after therapy). They consisted of patients receiving prophylactic treatments after being confirmed to have a risk of rupture of gastric varices (16 prophylactic cases) and those with a history of bleeding and receiving palliative treatments to prevent rebleeding (two palliative cases). To evaluate liver functions, blood tests before the therapy, just after the therapy and at 1, 3, 6 and 12 months after the therapy were retrospectively examined and the levels of albumin, total bilirubin (T.Bil), ALT, choline esterase (ChE), platelets and the Child-Pugh classification were assessed. The albumin levels tended to increase after the therapy, and the level at 6 months after the therapy was significantly higher than the pre-treatment value (P=0.0311). At 1 year after the therapy, the level was higher than the pre-treatment value, but there was no significant difference. The ChE level tended to decrease just after the therapy, but it tended to be increased at 3 and 6 months after the therapy. Although significant improvement was not seen in T.Bil, ALT, platelet levels or the Child-Pugh classification after the therapy, none of these worsened. Endoscopic gastric variceal ligation therapy significantly improved liver functions, or at least albumin synthesis.
Segawa
Makoto
M
Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine, Minami Kogushi 1-1-1, Yamaguchi 755-8505, Ube, Japan
Sakaida
Isao
I
Takeo
Yoshifumi
Y
Harada
Toshiya
T
Yoshida
Tomoharu
T
Okita
Kiwamu
K