Embolization combined with endoscopic variceal ligation for the treatment of esophagogastric variceal bleeding in patients with cirrhosis.
BACKGROUND
Esophagogastric variceal bleeding caused by cirrhosis is a kind of emergent condition in the clinic. This study was conducted to explore the therapeutic effect and superiority of embolization of gastric fundus varices combined with endoscopic variceal ligation (EVL) of esophageal varices for the treatment of patients with esophagogastric variceal bleeding caused by cirrhosis.


METHODS
Totally 172 patients were diagnosed by endoscopic examination within 24 hours of hospitalization with active gastric fundus variceal bleeding and grade II above esophageal varices caused by cirrhosis. Other causes leading to upper digestive tract bleeding were excluded. Patients were randomly divided into a control group (n = 82) and a therapy group (n = 90) following a random number table method. For the former, embolization for gastric fundus varices was performed, then an EVL for esophageal varices was performed 2 months later. For the therapy group, embolization for gastric fundus varices and EVL for esophageal varices were performed at the same time.


RESULTS
The rate of emergency hemostasis in the therapy group was 100.0%, higher than that in the control group (87.8%, P < 0.05). The rate of early rebleeding in the therapy group was 6.7% while the rate in the control group was 23.6% (P < 0.05). No complications related to treatment occurred in both groups.


CONCLUSIONS
Embolization for gastric fundus varices combined with EVL for esophageal varices is a safe and effective method for the treatment of patients with esophagogastric variceal bleeding caused by cirrhosis.
Huang
Liu-Ye
LY
Department of Gastroenterology, Yuhuangding Hospital, Medical College of Qingdao University, Yantai 264000, China.
Cui
Jun
J
Wu
Cheng-Rong
CR
Liu
Yun-Xiang
YX
D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic; D016145:Endoscopy, Digestive System; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D006487:Hemostasis; D006801:Humans; D008026:Ligation; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged