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

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

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

Natsuhiko Kameda,Kazuhide Higuchi,Masatsugu Shiba,Kaori Kadouchi,Hirohisa Machida,Hirotoshi Okazaki,Tetsuya Tanigawa,Toshio Watanabe,Kazunari Tominaga,Yasuhiro Fujiwara,Kenji Nakamura,Tetsuo Arakawa,Natsuhiko Kameda,Kazuhide Higuchi,Masatsugu Shiba,Kaori Kadouchi,Hirohisa Machida,Hirotoshi Okazaki,Tetsuya Tanigawa,Toshio Watanabe,Kazunari Tominaga,Yasuhiro Fujiwara,Kenji Nakamura,Tetsuo Arakawa,

AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSION: We should examine the hemodynamics before treatment of GV irrespective of the existence of GRS. If this hemodynamic examination reveals that the drainage vein connects directly to the inferior vena cava in GV without GRS, BRTO may be an effective treatment for GV with GRS.

Management of gastric fundal varices without gastro-renal shunt in 15 patients. Publishing Authors By Initials

N Kameda,K Higuchi,M Shiba,K Kadouchi,H Machida,H Okazaki,T Tanigawa,T Watanabe,K Tominaga,Y Fujiwara,K Nakamura,T Arakawa,N Kameda,K Higuchi,M Shiba,K Kadouchi,H Machida,H Okazaki,T Tanigawa,T Watanabe,K Tominaga,Y Fujiwara,K Nakamura,T Arakawa,

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

PUBLICATION TYPE: Journal Article

Journal: World journal of gastroenterology : WJG

VOLUME: 14

Page Numbers: 448-53

Journal Abbreviation: World J. Gastroenterol.

ISSN: 1007-9327

DAY: 21

MONTH: Jan

YEAR: 2008

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

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LANGUAGE: eng

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AFFILIATION: Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan. higuchi@poh.osaka-med.ac.jp.

Country: China

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MEDLINETA: World J Gastroenterol

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