Efficacy of argon plasma coagulation in gastric vascular ectasia in patients with liver cirrhosis.
OBJECTIVE
To determine the efficacy of Argon Plasma Coagulation (APC) in terms of improvement in hemoglobin level and disappearance of telangiectasia as endoscopic treatment for Gastric Antral Vascular Ectasia (GAVE) and Diffuse Antral Vascular Ectasia (DAVE) syndrome in liver cirrhosis.


METHODS
Quasi experimental study.


METHODS
Department of Gastroenterology and Hepatology of Shaikh Zayed Hospital/ Federal Postgraduate Medical Institute, Lahore, from January, 2006 to July, 2007.


METHODS
Cirrhotic patient with gastric vascular ectasia were enrolled and followed-up for 18 months with repeated sessions of APC. Efficacy of APC was evaluated on the basis of patient's symptoms, transfusion requirements and hemoglobin levels. APC was performed by using ERBE generator set at 60 W and flow rate 2.0 L/min using primarily endfiring probes.


RESULTS
Fifty patients were enrolled in the study. Mean age was 55.78+1.24 years with 32 males and 18 females giving a male to female ratio 1.7:1. Forty two patients were in Child's Class C and 8 in Child's Class B. Presenting complaints were malena and anemia. Two hundred and fifty three APC sessions were carried out; mean 5.06+1.5 sessions per patient. Mean follow-up period after the last session was 8.5+3.7 months. Mean increase in the hemoglobin level was 1.35+0.24 g/dl. There was no death of any patient during the study period.


CONCLUSIONS
Treatment with APC is an effective and safe method to decrease blood loss in patients with GAVE and DAVE.
Department of Gastroenterology, Shaikh Zayed Hospital, Lahore. afzalbhatti@hotmail.com
Muhammad Afzal
MA
Bhatti
Anwaar A
AA
Khan
Altaf
A
Alam
Arshad K
AK
Butt
Farzana
F
Shafqat
Kashif
K
Malik
Joher
J
Amin
Waqar
W
Shah
D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000209:etiology; D001128:Argon; D001803:Blood Transfusion; D005260:Female; D020252:Gastric Antral Vascular Ectasia / Q000150:complications / Q000601:surgery* / Q000628:therapy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D017075:Laser Coagulation / Q000295:instrumentation* / Q000379:methods; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013684:Telangiectasis / Q000209:etiology
D006454:Hemoglobins; D001128:Argon