M. Hashizume et al., ERADICATION OF LARGE GASTRIC VARICES BY SCLEROTHERAPY COMBINED WITH PERCUTANEOUS TRANSHEPATIC OBLITERATION, Hepato-gastroenterology, 44(13), 1997, pp. 221-226
Background/Aims: The long-term results of a combination. therapy of sc
lerotherapy with percutaneous transhepatic obliteration (PTO) was revi
ewed in 37 patients with large gastric varices. The study suggests tha
t sclerotherapy combined with PTO can. safely and effectively eradicat
e large gastric varices as an alternative approach to surgery. Complet
e eradication has also been shown. to prevent the recurrence ofgastric
varices. Material and Methods: The long-term results of a combination
. therapy of sclerotherapy with PTO was reviewed in 37 patients with l
arge gastric varices. Results: Complete eradication, of the gastric va
rices was obtained in. 26 patients (70.3%). There was no recurrence of
the varices in whom complete eradication had been obtained, but in. 1
1 patients with incomplete eradication gastric varices recurred during
the mean follow-up period of 37.5 months. Bleeding occurred in 4 afte
r the treatment and one patient died of massive bleeding from the recu
rrent gastric varices. There were no major complications with the proc
edure except for one who had a peripheral pulmonary arterial embolizat
ion as a result of a steel coil used for the PTO. Conclusion: This stu
dy suggests that sclerotherapy combined with PTO can effectively and s
afely eradicate Large gastric varices and is an. alternative approach
to surgery for treating patients with gastric varices. It is also show
n. that complete eradication Leads to a prevention of recurrence of ga
stric varices.