Journal of Hepato-Biliary-Pancreatic Sciences

, Volume 17, Issue 6, pp 898–903 | Cite as

Portal hemodynamics and clinical outcomes of patients with gastric varices after balloon-occluded retrograde transvenous obliteration

  • Akiyoshi Kasuga
  • Hideaki Mizumoto
  • Shoichi Matsutani
  • Akitoshi Kobayashi
  • Tsunehiro Endo
  • Takeshi Ando
  • Seigo Yukisawa
  • Hitoshi Maruyama
  • Osamu Yokosuka
Original article

Abstract

Background

Long-term hemodynamic effects and clinical outcomes after balloon-occluded retrograde transvenous obliteration (B-RTO) remain unclear. The purpose of this study was to evaluate long-term clinical results and effects on portal hemodynamics after B-RTO for the treatment of gastric varices with spontaneous gastrorenal shunt.

Methods

A total of 21 patients with cirrhosis and gastric varices treated by B-RTO were evaluated. The cumulative survival rate was calculated, portal blood flow was measured by Doppler ultrasonography, and liver function was estimated on the basis of Child-Pugh classification before and 1 year after B-RTO.

Results

Gastric varices disappeared or decreased markedly in size in all patients. Overall cumulative survival rates at 1, 3 and 5 years were 90.48, 71.11 and 53.71%, respectively. Portal blood flow increased significantly from 681.9 ± 294.9 to 837.0 ± 279.1 ml/min (P = 0.0125) after B-RTO. Child-Pugh score was not significantly changed (P = 0.755) after obliteration, but serum albumin was elevated significantly from 3.49 ± 0.49 to 3.75 ± 0.53 g/dl (P = 0.0459). The ascites score was significantly increased (P = 0.0455) after B-RTO, but all cases of ascites could be controlled with medication.

Conclusions

Balloon-occluded retrograde transvenous obliteration is a safe and effective treatment for gastric varices with gastrorenal shunt. Portal blood flow and serum albumin parameters are increased, and liver function is unchanged after B-RTO.

Keywords

Balloon-occluded retrograde transvenous obliteration (B-RTO) Portal hemodynamics Doppler ultrasonography 

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Copyright information

© Japanese Society of Hepato-Biliary-Pancreatic Surgery and Springer 2010

Authors and Affiliations

  • Akiyoshi Kasuga
    • 1
    • 3
  • Hideaki Mizumoto
    • 1
  • Shoichi Matsutani
    • 2
  • Akitoshi Kobayashi
    • 1
  • Tsunehiro Endo
    • 1
  • Takeshi Ando
    • 1
  • Seigo Yukisawa
    • 2
  • Hitoshi Maruyama
    • 2
  • Osamu Yokosuka
    • 2
  1. 1.Department of GastroenterologyFunabashi Municipal Medical CenterChibaJapan
  2. 2.Department of Medicine and Clinical Oncology, Graduate School of MedicineChiba UniversityChibaJapan
  3. 3.Department of GastroenterologyChiba University School of MedicineChibaJapan

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