title: Percutaneous transhepatic embolization of gastroesophageal varices combined with partial splenic embolization for the treatment of variceal bleeding and hypersplenism.
abstract: This study aims to evaluate the therapeutic results of percutaneous transhepatic embolization of gastroesophageal varices combined with partial splenic embolization in patients with liver cirrhosis, and to explore the role of this minimally invasive treatment as an alternative to surgery. 25 patients with liver cirrhosis were received percutaneous transhepatic embolization of gastroesophageal varices combined with partial splenic embolization. Another 25 patients with liver cirrhosis underwent Hassab's operation. They were followed up, and received endoscopy, B ultrasound, liver function and hematologic examination at 24 months after the therapy. In minimal invasive group, before treatment and after 24 month following up after treatment, improved varices, improved portal hypertension and improved hypersplenism were showed comparing with the surgery group, and that they were measured by endoscopic visualization, ultrasound and blood counts. the white blood cell and platelet count were 2.33±0.65 (10(9)/L) and 3.63±1.05 (10(10)/L), 7.98±3.0 (10(9)/L) and 16.3±9.10 (10(10)/L) (P<0.05); the diameter of the portal vein were 1.47±0.25 cm, 1.31±0.23 cm (P<0.05). Esophageal varices passed from grade III to lower grade II in 11 patients, and from grade II to lower grade I in 6 patients at 24 month following up. In surgical group, the white blood cell and platelet count were 2.2±0.60 (10(9)/L), 4.1±1.25 (10(10)/L) before treatment; 9.3±2.56 (10(9)/L), 32.1±12.47 (10(10)/L) after the treatment at 24 month following up (P<0.05). The diameter of the portal vein were 1.43±0.22 cm before the treatment and 1.28±0.18 cm after the treatment (P<0.05). Esophageal varices passed from grade III to lower grade II in 13 patients, and from grade II to lower grade I in 7 patients. The combination of PGEV and PSE can be considered as an option for the treatment of variceal bleeding with hypersplenism.
authors.affiliation: Division of Interventional Radiology, Tang Du Hospital, The Fourth Military Medical University Xian 710038, China.
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Gong
authors.affiliation: Division of Interventional Radiology, Baoji Zhongxin Hospital Baoji 710038, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Xue
authors.affiliation: Division of Surgery, Tang Du Hospital, The Fourth Military Medical University Xian 710038, China.
authors.forename: Yuan-Kui
authors.initials: YK
authors.lastname: Chu
authors.affiliation: Division of Surgery, Tang Du Hospital, The Fourth Military Medical University Xian 710038, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Division of Interventional Radiology, Tang Du Hospital, The Fourth Military Medical University Xian 710038, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.affiliation: Division of Interventional Radiology, Baoji Zhongxin Hospital Baoji 710038, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Quan
authors.affiliation: Department of Biostatistics, The Fourth Military Medical University Xian 710032, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Yang
authors.affiliation: Division of Interventional Radiology, Tang Du Hospital, The Fourth Military Medical University Xian 710038, China.
authors.forename: Zhi-Min
authors.initials: ZM
authors.lastname: Wang
authors.affiliation: Division of Interventional Radiology, Tang Du Hospital, The Fourth Military Medical University Xian 710038, China.
authors.forename: Zhi-Qun
authors.initials: ZQ
authors.lastname: Wu
keywords: Partial splenic embolization; hypersplenism; percutaneous transhepatic embolization of gastroesophageal varices; variceal bleeding