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Study of hemodynamic changes in portal systemic shunts and their relation to variceal relapse after endoscopic variceal ligation combined with ethanol sclerotherapy

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Abstract

Background

Among the factors influencing variceal relapse after endoscopic treatment, portal hemodynamic changes, especially in portal systemic shunts, could be the most important factor because hemodynamics are directly related to the development of esophageal varices. We aimed to clarify the influence of endoscopic treatment for esophageal varices on portal systemic shunts as well as its predictive value for variceal relapse.

Methods

Fifty patients who underwent combined endoscopic variceal ligation and injection sclerotherapy were examined with sonography and portography.

Results

Decrease of diameter, hepatopetal flow direction in the left gastric vein, or the presence of non-varices portal systemic shunt were sonographic findings related to a low incidence of variceal relapse. The presence of blood flow in and around the esophagus on venograms was highly predictive for variceal relapse. In patients with such venograms, non-varices portal systemic shunts did not develop.

Conclusions

Sonographic assessment of hemodynamic changes in portal systemic shunt could be useful for estimating the results of endoscopic treatment for esophageal varices.

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Authors and Affiliations

  1. Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Kenji Ito, Shoichi Matsutani, Hitoshi Maruyama, Taro Akiike, Hiromasa Nomoto, Toshiya Suzuki, Takeshi Fukuzawa, Hideaki Mizumoto & Hiromitsu Saisho

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  1. Kenji Ito
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  2. Shoichi Matsutani
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Ito, K., Matsutani, S., Maruyama, H. et al. Study of hemodynamic changes in portal systemic shunts and their relation to variceal relapse after endoscopic variceal ligation combined with ethanol sclerotherapy. J Gastroenterol 41, 119–126 (2006). https://doi.org/10.1007/s00535-005-1730-9

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  • DOI: https://doi.org/10.1007/s00535-005-1730-9

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