Management of gastric fundal varices without gastro-renal shunt in 15 patients.

World Journal of Gastroenterology : WJG
Natsuhiko KamedaTetsuo Arakawa

Abstract

To examine the portal hemodynamics of gastric fundal varices (GV) without gastro-renal shunt (GRS), and to retrospectively investigate the effects of various kinds of treatment on eradication. Ninety-four liver cirrhosis patients at high-risk of GV were treated in our hospital and enrolled in this study. We retrospectively examined their characteristics, liver function, and portal hemodynamics of GV. We performed balloon-occluded retrograde transvenous obliteration (BRTO) at first. If it was not technically possible to perform BRTO, endoscopic injection sclerotherapy using alpha-cyanoacrylate glue (CA) or percutaneous transhepatic obliteration (PTO) was performed. Among the 94 patients, a GRS was present in 79 (84.0%), and absent in the remaining 15 (16.0%). The subphrenic vein was connected to the inferior vena cava as the drainage vein in 13 (86.7%) out of the 15 cases without GRS. We performed BRTO in 6 patients, CA in 4 patients and PTO in 5 patients. The eradication rate was 100% for each procedure, but the rate of early recurrence within 6 mo was 16.7% for BRTO, 50.0% for CA and 40.0% for PTO, respectively. We should examine the hemodynamics before treatment of GV irrespective of the existence of GRS. If this hemodynamic ...Continue Reading

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Citations

Apr 12, 2012·World Journal of Gastroenterology : WJG·Tetsuo SonomuraKazushi Kishi
Oct 5, 2013·Cardiovascular and Interventional Radiology·Wael E SaadSteven C Rose
Aug 10, 2013·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Tsung-Jung LiangPo-Min Chang
Dec 20, 2011·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Tomohiko AkahoshiYoshihiko Maehara
Aug 10, 2013·Journal of Gastroenterology and Hepatology·Yukinori ImaiSatoshi Mochida
Oct 10, 2014·Acta Radiologica Short Reports·Rika YoshimatsuKotaro Okuda
Nov 12, 2021·Clinical Journal of Gastroenterology·Suguru HiroseKiichiro Tsuchiya

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