ERADICATION OF LARGE GASTRIC VARICES BY SCLEROTHERAPY COMBINED WITH PERCUTANEOUS TRANSHEPATIC OBLITERATION

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.