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Improved Prognosis of Cirrhosis Patients with Esophageal Varices and Thrombocytopenia Treated by Endoscopic Variceal Ligation Plus Partial Splenic Embolization

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Abstract

The aim of this study was to assess the efficacy of the combination of endoscopic variceal ligation (EVL) and partial splenic embolization (PSE) compared with EVL alone in cirrhosis patients with thrombocytopenia. In a prospective study, 84 cirrhosis patients with esophageal varices and thrombocytopenia (platelet count < 50,000/mm3) underwent EVL plus PSE (N = 42) or EVL alone (N = 42). Primary end points assessed during the follow-up period included the recurrence of varices, progression to variceal bleeding, and death. Comparison between combined treatment and variceal ligation alone by multivariate analysis showed a hazard ratio of 0.44 for the recurrence of varices (P = 0.02), 0.19 for progression to variceal bleeding (P = 0.01), and 0.31 for death (P = 0.04). These results suggest that the combination of EVL plus PSE can prevent the recurrence of varices, progression to variceal bleeding, and death in cirrhosis patients with esophageal varices and thrombocytopenia.

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Authors and Affiliations

  1. Division of Hepatology, Department of Medicine, Kawasaki Medical School, Okayama, Japan

    Kenji Ohmoto MD, Naoko Yoshioka, Yasuyuki Tomiyama MD, Norikuni Shibata, Michihiko Takesue MD, Koji Yoshida MD, Makoto Kuboki MD & Shinichiro Yamamoto MD

  2. Division of Hepatology, Department of Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan

    Kenji Ohmoto MD

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  1. Kenji Ohmoto MD
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  2. Naoko Yoshioka
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  3. Yasuyuki Tomiyama MD
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  4. Norikuni Shibata
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Correspondence to Kenji Ohmoto MD.

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Ohmoto, K., Yoshioka, N., Tomiyama, Y. et al. Improved Prognosis of Cirrhosis Patients with Esophageal Varices and Thrombocytopenia Treated by Endoscopic Variceal Ligation Plus Partial Splenic Embolization. Dig Dis Sci 51, 352–358 (2006). https://doi.org/10.1007/s10620-006-3137-8

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  • DOI: https://doi.org/10.1007/s10620-006-3137-8

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