Improved prognosis of cirrhosis patients with esophageal varices and thrombocytopenia treated by endoscopic variceal ligation plus partial splenic embolization.
The aim of this study was to assess the efficacy of the combination of endoscopic variceal ligation (EVL) and partial splenic embolization (PSE) compared with EVL alone in cirrhosis patients with thrombocytopenia. In a prospective study, 84 cirrhosis patients with esophageal varices and thrombocytopenia (platelet count < 50,000/mm(3)) underwent EVL plus PSE (N = 42) or EVL alone (N = 42). Primary end points assessed during the follow-up period included the recurrence of varices, progression to variceal bleeding, and death. Comparison between combined treatment and variceal ligation alone by multivariate analysis showed a hazard ratio of 0.44 for the recurrence of varices (P = 0.02), 0.19 for progression to variceal bleeding (P = 0.01), and 0.31 for death (P = 0.04). These results suggest that the combination of EVL plus PSE can prevent the recurrence of varices, progression to variceal bleeding, and death in cirrhosis patients with esophageal varices and thrombocytopenia.
Division of Hepatology, Department of Medicine, Kawasaki Medical School, Okayama, Japan. ohmotok@med.kawasaki-m.ac.jp
Kenji
K
Ohmoto
Naoko
N
Yoshioka
Yasuyuki
Y
Tomiyama
Norikuni
N
Shibata
Michihiko
M
Takesue
Koji
K
Yoshida
Makoto
M
Kuboki
Shinichiro
S
Yamamoto
D000368:Aged; D004621:Embolization, Therapeutic; D004724:Endoscopy; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006971:Hypersplenism / Q000150:complications / Q000628:therapy*; D008026:Ligation; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013921:Thrombocytopenia / Q000150:complications*; D016896:Treatment Outcome