Endoscopic Treatment of Esophageal Varices: Selection of Treatment Method

  • Katsutoshi ObaraEmail author


In Japan, endoscopic treatment, which includes endoscopic injection sclerotherapy and endoscopic variceal ligation, is the first-line treatment for esophageal varices. However, as both of these methods have their respective pros and cons, individual patient conditions and portal hemodynamics must be fully studied so that an optimal treatment method can be selected for each patient. More precisely, the patient conditions that need to be studied include the residual liver function and the presence of hepatocellular carcinoma. In addition, endoscopic ultrasonography is useful for studying the portal hemodynamics in the immediate surroundings of varices, while three-dimensional computed tomography is useful for studying the overall portal region. Recently, high-resolution imaging of endoscopic ultrasonography has made it possible to evaluate the development of periesophageal veins and perforating veins, which also contributes to the selection of an optimal treatment method.


Esophageal varices Endoscopic injection sclerotherapy Endoscopic variceal ligation EUS MDCT 


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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Advanced Gastrointestinal EndoscopyFukushima Medical UniversityFukushimaJapan

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