Therapeutic results of endoscopic variceal ligation for acute bleeding of oesophageal and gastric varices

1997 ◽  
Vol 12 (4) ◽  
pp. 331-335 ◽  
Author(s):  
TOSHIYA HARADA ◽  
TOMOHARU YOSHIDA ◽  
TOSHINORI SHIGEMITSU ◽  
YOSHIFUMI TAKEO ◽  
MASAHIRO TADA ◽  
...  
Keyword(s):  
Gastric Varices ◽  
Endoscopic Variceal Ligation ◽  
Acute Bleeding ◽  
Therapeutic Results

scholarly journals Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective Study

2021 ◽  
Author(s):  
Pushpinder S. Khera ◽  
Pawan K. Garg ◽  
Sarbesh Tiwari ◽  
Narendra Bhargava ◽  
Taruna Yadav ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Success ◽  
Gastric Varices ◽  
Early Recurrence ◽  
Single Institution ◽  
Vascular Plug ◽  
Acute Bleeding ◽  
Sclerosing Agents ◽  
Age Range ◽  
Refractory Hepatic Encephalopathy

Abstract Introduction Retrograde transvenous obliteration (RTO) with the assistance of a balloon (BRTO) or a vascular plug (PARTO) is an established method for treating gastric varices (GVs) secondary to portal hypertension. Most of the available studies on RTO have used lipiodol along with sclerosing agents like ethanolamine oleate or sodium tetradecyl sulfate (STS). We evaluated the safety and efficacy of RTO for treating GVs using STS as a sclerosant without lipiodol. Materials and Methods Sixteen patients (nine men, age range 16–74 years) were included in this retrospective study. Twelve patients presented with acute bleeding, two with chronic bleeding, one with large varices without bleeding, and one with refractory hepatic encephalopathy (HE). BRTO was attempted in 14 patients and PARTO in 2 patients. The technical and clinical success and complications of RTO were studied. Results The RTO procedure was technically successful in 14 (14/16, 87.5%) patients, with 13 (13/14, 93%) obtaining clinical success. One patient died due to the early recurrence of bleeding. Three patients had minor intraprocedural complications. Conclusion Retrograde gastric variceal obliteration using STS is safe and technically feasible with high technical and clinical success and low complication rate.

scholarly journals Endoscopic Variceal Ligation for Treatment of Bleeding Varices

1992 ◽  
Vol 6 (4) ◽  
pp. 213-217
Author(s):  
John S Goff
Keyword(s):  
Combination Therapy ◽  
Complication Rate ◽  
Esophageal Varices ◽  
Low Dose ◽  
Prophylactic Treatment ◽  
Gastric Varices ◽  
Effective Therapy ◽  
New Technique ◽  
Endoscopic Variceal Ligation ◽  
High Complication Rate

Endoscopic variceal ligation (EVL) was developed as an alternative to endoscopic variceal sclerosis (ES) because of the latter's high complication rate. The new technique involves placement of small elastic bands around the variceal channels in the distal esophagus. Initial open trials with EVL showed that it was safe and effective therapy for bleeding esophageal varices. EVL can be used emergently to control actively hemorrhaging varices and electively to eradicate varices with repeated sessions. When compareJ directly with results obtained with ES retrospectively and prospectively, EVL is equal or superior in preventing rebleeding while causing many fewer complications. Combining the two techniques may be even more effective than either alone at eradicating varices. Combination therapy has achieved eradication of varices in an average of three sessions, which is one to three fewer sessions than generally reported to achieve eradication with EVL or ES alone. Combination therapy has also been used to control bleeding gastric varices effectively. EVL, alone or with low dose ES, seems to be the safest and most effective endoscopic means for controlling bleeding from esophageal or gastric varices. EVL needs to be evaluated for prophylactic treatment of esophageal varices since its low morbidity profile may make it more suitable than ES for prophylactic treatment.

Portal hypertension and variceal bleeding

2020 ◽  
pp. 3068-3080
Author(s):  
Marcus Robertson ◽  
Peter Hayes
Keyword(s):  
Portal Hypertension ◽  
Variceal Bleeding ◽  
Developed Countries ◽  
Gastric Varices ◽  
Secondary Prophylaxis ◽  
Medical Emergency ◽  
Endoscopic Management ◽  
Recurrent Bleeding ◽  
Endoscopic Variceal Ligation ◽  
Complications Of Cirrhosis

Portal hypertension refers to a pathological elevation of pressure in the veins that carry blood from the splanchnic organs to the liver which, in developed countries, most commonly results from increased intrahepatic resistance to portal flow as a result of liver cirrhosis. Portal hypertension is associated with development of many of the complications of cirrhosis and confers a poor prognosis. Acute variceal bleeding is a life-threatening medical emergency which remains a leading cause of death in patients with cirrhosis. Endoscopic variceal ligation and endoscopic variceal obturation remain the treatments of choice for bleeding oesophageal and gastric varices respectively. Advances in care including prophylactic antibiotics, vasoactive drugs, and transjugular intrahepatic portosystemic shunt in patients with bleeding refractory to early endoscopic management has improved the mortality rate, which is now estimated at 15 to 20%. Secondary prophylaxis of variceal bleeding with nonselective β‎-blockers and/or endoscopic variceal ligation reduces recurrent bleeding and has been demonstrated to improve survival.

scholarly journals Defining the advantages and exposing the limitations of endoscopic variceal ligation in controlling acute bleeding and achieving complete variceal eradication

2020 ◽  
Vol 12 (10) ◽  
pp. 365-377
Author(s):  
Jake Krige ◽  
Eduard Jonas ◽  
Urda Kotze ◽  
Christo Kloppers ◽  
Karan Gandhi ◽  
...  
Keyword(s):  
Endoscopic Variceal Ligation ◽  
Acute Bleeding

scholarly journals Balloon-Occluded Retrograde Transvenous Obliteration (BRTO): A Novel Method of Obliterating Gastric Varices. Report of Six Cases and Review of Literature

2020 ◽  
Vol 9 (2) ◽  
pp. 89-93
Author(s):  
Ajit Thapa ◽  
Dinesh Koirala ◽  
Rahul Pathak ◽  
Dinesh Chataut ◽  
Sashi Sharma ◽  
...  
Keyword(s):  
Balloon Catheter ◽  
Invasive Procedure ◽  
Gastric Varix ◽  
Gastric Varices ◽  
Minimal Invasive ◽  
Balloon Occlusion ◽  
Endoscopic Variceal Ligation ◽  
Review Of Literature ◽  
Gastroesophageal Varices ◽  
Novel Method

Portal hypertension results in various complications, gastroesophageal varices being one of them. Although less common than esophageal varices, gastric varices are difficult to obliterate and carry a higher mortality rate when bleeding occurs. They are less amenable to sclerotherapy, endoscopic variceal ligation. Balloon-Occluded Retrograde Transvenous Obliteration (BRTO) has been developed as a minimal invasive procedure to obliterate gastric varices. BRTO is an endovascular procedure where a balloon catheter is inserted into a draining vein of gastric varix, and the sclerosant can be injected into the varices through the catheter during balloon occlusion. We report six cases where BRTO was done for gastric varices obliteration.

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