Digestive Diseases and Sciences

, Volume 51, Issue 2, pp 352–358 | Cite as

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

  • Kenji OhmotoEmail author
  • Naoko Yoshioka
  • Yasuyuki Tomiyama
  • Norikuni Shibata
  • Michihiko Takesue
  • Koji Yoshida
  • Makoto Kuboki
  • Shinichiro Yamamoto


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.

Key Words

liver cirrhosis portal hypertension esophageal varices thrombocytopenia endoscopic variceal ligation partial splenic embolization 


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Copyright information

© Springer Science + Business Media, Inc. 2006

Authors and Affiliations

  • Kenji Ohmoto
    • 1
    • 2
    Email author
  • Naoko Yoshioka
    • 1
  • Yasuyuki Tomiyama
    • 1
  • Norikuni Shibata
    • 1
  • Michihiko Takesue
    • 1
  • Koji Yoshida
    • 1
  • Makoto Kuboki
    • 1
  • Shinichiro Yamamoto
    • 1
  1. 1.Division of Hepatology, Department of MedicineKawasaki Medical SchoolOkayamaJapan
  2. 2.Division of Hepatology, Department of MedicineKawasaki Medical SchoolOkayamaJapan

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