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KMID : 0614620110570050302
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Korean Journal of Gastroenterology
2011 Volume.57 No. 5 p.302 ~ p.308
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Comparison among Endoscopic Variceal Obliteration, Endoscopic Band Ligation, and Balloon-occluded Retrograde Transvenous Obliteration for Treatment of Gastric Variceal Bleeding
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Min Seul-Ki
Kim Sang-Gyune
Kim Young-Seok
Bae Jun-Yong
Lee Jong-Chan
Lee Sae-Hwan
Kim Hong-Soo
Jung Seung-Won
Jang Jae-Young
Moon Jong-Ho
Lee Moon-Sung
Kim Boo-Sung
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Abstract
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Background/Aims : Endoscopic variceal obliteration (EVO), endoscopic variceal ligation (EVL), and balloon-occluded retrograde transvenous obliteration (BRTO) are used to manage gastric variceal bleeding. We compared the re-bleeding rates and survival times of these modalities.
Methods: The study enrolled 103 patients with suspected gastric variceal bleeding between July 2001 and May 2009. For the management of gastric variceal bleeding, 52 patients underwent EVO; 36, EVL; and 15, BRTO. We evaluated their laboratory results and vital signs, and calculated the Child score, Child classification, and Model for End-stage Liver Disease score. Rebleeding was defined as new-onset hematemesis, hematochezia, melena, or endoscopically proven bleeding. Time-to-rebleeding and survival time were examined by Kaplan-Meyer analysis. A value of p<0.05 indicated statistical significance.
Results: There were no significant differences in baseline characteristics among the three groups. The overall follow-up period averaged 65.13 months. During follow-up, rebleeding occurred in 17 patients (11 EVO, 5 EVL, and 1 BRTO). The times-to-rebleeding were 63.59, 75.79, and 51.41 months for EVO, EVL, and BRTO, respectively, and did not differ significantly (p=0.515). The median survival times were 77.42, 70.14, and 42.79 months, respectively, and also were not different significantly (p=0.978).
Conclusions: There were no significant differences in the time-to-rebleeding or survival time among EVO, EVL, and BRTO. Further prospective, large-scale studies are needed.
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KEYWORD
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Esophageal and gastric varices, Gastrointestinal hemorrhage, Liver cirrhosis, Treatment
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