Skip to main content
SpringerLink
Log in
Book cover

Neuere Aspekte der Sklerosierungstherapie pp 131–146Cite as

Indikationen, Technik und Langzeitergebnisse der paravasalen Akutsklerosierung, der elektiven und prophylaktischen Injektion von Ösophagusvarizen beim Leberzirrhotiker

  • Chapter

  • 26 Accesses

Zusammenfassung

Blutungen aus Ösophagusvarizen gehören zu den gastrointestinalen Blutungen mit der höchsten Sterblichkeit und der schlechtesten Prognose. Sie werden durch einen Pfortaderhochdruck auf dem Boden eines intrahepatischen Blocks hervorgerufen, dessen Ursachen bekannt sind. Dagegen weiß man wenig über die genauen Faktoren, die eine Blutung auslösen. Zweifellos spielt die Höhe des Pfortaderdrucks [33], vor allem ein plötzlicher Druckanstieg, eine ebenso große Rolle wie der starke Ausprägungsgrad der Ösophagusvarizen, für den unsere Arbeitsgruppe [19] eine Klassifikation (Abb. 1) beschrieben hat. In dieser Klassifikation haben wir darauf hingewiesen, daß bestimmte charakteristische Merkmale im Erscheinungsbild der Varizen, wie z. B. Epithelverdünnungen und Teleangiektasien auf eine Blutungsgefahr hinweisen können.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Alwmark A, Bengmark S, Börjesson B et al. (1982) Emergency and long term endoscopic esophageal sclerotherapy of bleeding esophageal varices. A prospective study of 509 consecutive cases. Scand J Gastroenterol 17:409–412

    Article  PubMed  CAS  Google Scholar 

  2. Barsoum MS, Boulus FI, EIRobby AA et al. (1982) Tamponade and injection sclerotherapy in the management of bleeding esophageal varices. Br J Surg 69:76–78

    Article  PubMed  CAS  Google Scholar 

  3. Burroughs AK, Sanchez A, Bass NM et al. (1983) Can endoscopic sclerotherapy influence significantly the course of cirrhotic patients who survive variceal bleeding? Gut 24:972–977

    Google Scholar 

  4. The Copenhagen Variceal Sclerotherapy Project (1984) Sclerotherapy after first variceal hemorrhage in cirrhosis, a randomized multicenter trial. N Engl J Med 311:1594–1600

    Article  Google Scholar 

  5. Crawfoord C, Frenckner T (1939) New surgical treatment of varicous veins of the esophagus. Acta Otolaryngol 27:422–429

    Article  Google Scholar 

  6. Fleig WE, Stange EF, Rüttenauer K, Ditschuneit H (1983) Emergency endoscopic sclerotherapy for bleeding esophageal varices: a prospective study in patients not responding to balloon tamponade. Gastrointest Endosc 29:8–14

    Article  PubMed  CAS  Google Scholar 

  7. Graham DY, Lacey-Smith J (1981) The course of patients after variceal hemorrhage. Gastroenterology 80:800–809

    PubMed  CAS  Google Scholar 

  8. Gregory P, Hartigan D, Amodeo R et al. (Multicenter study) (1986) Prophylactic sclerotherapy for esophageal varices in alcoholic liver disease: results of a cooperative randomized trial (abstr). Gastroenterology 92:1414

    Google Scholar 

  9. Johnston GW, Rodgers HW (1973) A review of 15 years experiences in the use of sclerotherapy in the control of acute hemorrhage from esophageal varices. Br J Surg 60:797–800

    Article  PubMed  CAS  Google Scholar 

  10. Kjaergaard J, Fischer A, Miskowiak J et al. (1982) Sclerotherapy of bleeding esophagal varices. Longterm results. Scand J Gastroenterol 17:363–367

    Article  PubMed  CAS  Google Scholar 

  11. Koch H, Henning H, Grimm H et al. (1986) Prophylactic sclerosing of esophageal varices — Results of a prospective controlled study. Endoscopy 18:40–43

    Article  PubMed  CAS  Google Scholar 

  12. Korula J, Balart LA, Radvan G, Zweiban BE, Larson AW, Kao HW, Yamada S (1985) A prospective randomized controlled trial of chronic esophageal variceal sclerotherapy. Hepa- tology 5:583–589

    Google Scholar 

  13. Larson AW, Cohen H, Zweiban B, Chapman D, Gourdji M, Korula J, Weiner J (1986) Acute esophageal variceal sclerotherapy. Results of a prospective randomized controlled trial. JAMA 255:487–500

    Article  Google Scholar 

  14. Lewis JW, Chung RS, Allison JG (1981) Injection sclerotherapy for control of acute variceal hemorrhage. Am J Surg 142:592–595

    Article  PubMed  CAS  Google Scholar 

  15. MacDougall BRD, Westaby D, Theodossi A etal. (1982) Increased long-term survival in variceal hemorrhage using injection sclerotherapy. Results of a controlled trial. Lancet 1:124–127

    Article  PubMed  CAS  Google Scholar 

  16. Nilsson F (1984) Management of active bleeding from esophagal varices by sclerotherapy. (5th International Symposium in Gastrointestinal Emergencies, Modena)

    Google Scholar 

  17. Palani CK, Abuabara S, Krafft AR, Jonasson O (1981) Endoscopic sclerotherapy in acute variceal hemorrhage. Am J Surg 141:164–168

    Article  PubMed  CAS  Google Scholar 

  18. Paquet K-J (1972) Indikationen und Ergebnisse der Sklerosierungstherapie bei Ösophagusvarizen. Therapiewoche 22:2622–2626

    Google Scholar 

  19. Paquet K-J (1982) Prophylactic endoscopic sclerosing treatment of the esophageal wall in varices — a prospective controlled randomised trial. Endoscopy 14:4–7

    Article  PubMed  CAS  Google Scholar 

  20. Paquet K-J (1983) Endoscopic paravariceal injection sclerotherapy of the esophagus — indications, technique, complications, results of a period of nearly 14 years. Gastrointest Endosc 29:310–317

    Article  PubMed  CAS  Google Scholar 

  21. Paquet K-J (1988) Indications and early and long-term results of paravariceal immediate, elective and prophylactic injection sclerotherapy. In: Idezuki Y (ed) Treatment of esophageal varices. Excerpta Medica, Amsterdam New York Oxford, pp 1–20

    Google Scholar 

  22. Paquet K-J, Feussner H (1985) Endoscopic sclerosis and esophageal balloon tamponade in accute hemorrhage from esophagogastric varices: a prospective controlled randomised trial. Hepatology 5:580–583

    Article  PubMed  CAS  Google Scholar 

  23. Paquet K-J, Oberhammer E (1978) Sclerotherapy of bleeding esophageal varices by means of endoscopy. Endoscopy 10:7–12

    Article  PubMed  CAS  Google Scholar 

  24. Paquet K-J, Kalk J-F, Koussouris P (1988) Immediate endoscopic sclerosis of bleeding esophageal varices — prospective evaluation over five years. Surg Endosc 23:18–23

    Article  Google Scholar 

  25. Paquet K-J, Mercado MA, Koussouris P, Kalk J-F, Siemens F, Cuan-Orozco F (1989) Improved results with selective distal splenorenal shunt in a highly selected patient population. Ann Surg 210:184–189

    Article  PubMed  CAS  Google Scholar 

  26. Piai G, Cipolletta, Claar M et al. (1988) Prophylactic sclerotherapy of high-risk esophageal varices: results of a multicentric prospective controlled trial. Hepatology 8:1495–1500

    Article  PubMed  CAS  Google Scholar 

  27. Raschke E, Paquet K-J (1973) Management of hemorrhage from esophageal varices using endoscopic method. Ann Surg 99:177–181

    Google Scholar 

  28. Russo A, Georgo G, Manjano A et al. (1989) Prophylactic sclerotherapy in non-alcoholic liver cirrhosis. Preliminary results of a prospective randomized trial. World J Surg 13:149- 153

    Google Scholar 

  29. Santangelo WC, Dueono MI, Estes BI etal. (1988) Prophylactic sclerotherapy of large esophageal varices. N Engl J Med 318:814–819

    Article  PubMed  CAS  Google Scholar 

  30. Sauerbruch T, Woitzka R, Kopeke W et al. (1988) Prophylactic sclerotherapy before the first episode of variceal hemorrhage in patients with cirrhosis. N Engl J Med 310:8–15

    Article  Google Scholar 

  31. Soederlund C (1985) Endoscopic sclerotherapy of esophageal varices, a clinical study. Acta Chir Scand [Suppl] 151:1–23

    Google Scholar 

  32. Soehendra N, deHeer K, Kempeneers I, Runge M (1983) Sclerotherapy of esophageal varices: acute arrest of gastrointestinal hemorrhage or long-term therapy? Endoscopy 15:136–140

    Article  PubMed  Google Scholar 

  33. Staritz M, Rambow A, Meyer zum Büschenfelde K-H (1987) Einfluß von Glycylpressin auf den Ösophagusvarizendruck bei Patienten mit Leberzirrhose und vorangegangener Varizen- blutung. Dtsch Med Wochenschr 112:1292–1295

    Article  PubMed  CAS  Google Scholar 

  34. Stray N, Jacobsen CD, Rosserland A (1982) Injection sclerotherapy of bleeding esophageal and gastric varices using a flexible endoscope. Acta Med Scand 2112:125–129

    Google Scholar 

  35. Takase Y, Osaki A, Orirj K et al. (1982) Injection sclerotherapy of esophageal varices for patients undergoing emergency and elective surgery. Surgery 92:474–479

    PubMed  CAS  Google Scholar 

  36. Terblanche J, Nordhover JMA, Bornman P et al. (1979) A prospective evaluation of injection sclerotherapy in the treatment of acute bleeding from esophageal varices. Surgery 85:239–245

    PubMed  CAS  Google Scholar 

  37. Terblanche J, Bornman TC, Kahn D et al. (1983) Failure of repeated injection sclerotherapy to improve long-term survival after esophageal variceal bleeding. A five year prospective controlled clinical trial. Lancet 11:1328–1332

    Google Scholar 

  38. Williams KD, Dawson JL (1979) Fibreoptic injection of esophageal varices. Br Med J 2:266–267

    Google Scholar 

  39. Witzel L, Wolbergs G, Merki H (1985) Prophylactic endoscopic sclerotherapy of esophageal varices. A prospective controlled study. Lancet 1:773–778

    Google Scholar 

Download references

Authors
  1. K.-J. Paquet
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. A. Gad
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J.-F. Kalk
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Anatomisches Institut, der Universität Freiburg, Albert-Str. 17, D-7800, Freiburg, Deutschland

    J. Staubesand

  2. Universitäts-Hautklinik, Hauptstr. 7, D-7800, Freiburg, Deutschland

    E. Schöpf

Rights and permissions

Reprints and permissions

Copyright information

© 1990 Springer-Verlag Berlin Heidelberg New York

About this chapter

Cite this chapter

Paquet, KJ., Gad, H.A., Kalk, JF. (1990). Indikationen, Technik und Langzeitergebnisse der paravasalen Akutsklerosierung, der elektiven und prophylaktischen Injektion von Ösophagusvarizen beim Leberzirrhotiker. In: Staubesand, J., Schöpf, E. (eds) Neuere Aspekte der Sklerosierungstherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-75756-3_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-75756-3_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-52660-5

  • Online ISBN: 978-3-642-75756-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation