Clinical outcomes of balloon-occluded retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage in Korean patients with liver cirrhosis: a retrospective multicenter study

被引：30

作者：

Jang, Se Young ^{[1
]}

Kim, Go Heun ^{[2
,3
]}

Park, Soo Young ^{[1
]}

Cho, Chang Min ^{[1
]}

Tak, Won Young ^{[1
]}

Kim, Jeong Han ^{[2
,3
]}

Choe, Won Hyeok ^{[2
,3
]}

Kwon, So Young ^{[2
,3
]}

Lee, Jae Myeong ^{[4
]}

Kim, Sang Gyune ^{[4
]}

Kim, Dae Yong ^{[4
]}

Kim, Young Seok ^{[4
]}

Lee, Se-Ok ^{[5
]}

Min, Yang Won ^{[5
]}

Lee, Joon Hyeok ^{[5
]}

Paik, Seung Woon ^{[5
]}

Yoo, Byung Chul ^{[5
]}

Lim, Jae Wan ^{[6
]}

Kim, Hong Joo ^{[6
]}

Cho, Yong Kyun ^{[6
]}

Sohn, Joo Hyun ^{[7
]}

Jeong, Jae Yoon ^{[7
]}

Lee, Yu Hwa ^{[7
]}

Kim, Tae Yeob ^{[7
]}

Kweon, Young Oh ^{[1
]}

机构：

[1] Kyungpook Natl Univ, Sch Med, Dept Internal Med, 130 Dondeok Ro, Daegu 700721, South Korea

[2] Konkuk Univ, Sch Med, Konkuk Univ Med Ctr, Dept Internal Med, Seoul, South Korea

[3] Konkuk Univ, Sch Med, Konkuk Univ Med Ctr, Dept Internal Med, Choongju, South Korea

[4] Soonchunhyang Univ, Coll Med, Dept Internal Med & Radiol, Bucheon, South Korea

[5] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Internal Med, Seoul, South Korea

[6] Sungkyunkwan Univ, Sch Med, Kangbook Samsung Hosp, Dept Internal Med, Seoul, South Korea

[7] Hanyang Univ, Hanyang Univ Guri Hosp, Sch Med, Dept Internal Med, Guri, South Korea

来源：

CLINICAL AND MOLECULAR HEPATOLOGY | 2012年 / 18卷 / 04期

关键词：

Balloon-occluded retrograde transvenous obliteration; Esophageal varices; Gastric varices; Liver cirrhosis; Variceal hemorrhage;

D O I：

10.3350/cmh.2012.18.4.368

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background/Aims: This study evaluated the clinical outcomes of balloon-occluded retrograde transvenous obliteration (BRTO) for the treatment of hemorrhage from gastric varices (GV) in Korean patients with liver cirrhosis (LC). Methods: We retrospectively analyzed data from 183 LC patients who underwent BRTO for GV bleeding in 6 universitybased hospitals between January 2001 and December 2010. Results: Of the 183 enrolled patients, 49 patients had Child-Pugh (CP) class A LC, 105 had CP class B, and 30 had CP class C at the time of BRTO. BRTO was successfully performed in 177 patients (96.7%). Procedure-related complications (e. g., pulmonary thromboembolism and renal infarction) occurred in eight patients (4.4%). Among 151 patients who underwent follow-up examinations of GV, 79 patients (52.3%) achieved eradication of GV, and 110 patients (72.8%) exhibited marked shrinkage of the treated GV to grade 0 or I. Meanwhile, new-appearance or aggravation of esophageal varices (EV) occurred in 54 out of 136 patients who underwent follow-up endoscopy (41.2%). During the 36.0 +/- 29.2 months (mean +/- SD) of follow-up, 39 patients rebled (hemorrhage from GV in 7, EV in 18, nonvariceal origin in 4, and unknown in 10 patients). The estimated 3-year rebleeding-free rate was 74.8%, and multivariate analysis showed that CP class C was associated with rebleeding (odds ratio, 2.404; 95% confidence-interval, 1.013-5.704; P= 0.047). Conclusions: BRTO can be performed safely and effectively for the treatment of GV bleeding. However, aggravation of EV or bleeding from EV is not uncommon after BRTO; thus, periodic endoscopy to follow-up of EV with or without prophylactic treatment might be necessary in LC patients undergoing BRTO.

引用

页码：368 / 374

页数：7

共 26 条

[1]

Akahane T, 1997, AM J GASTROENTEROL, V92, P1026

[2] Long-term results of balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding and risky gastric varices: A 10-year experience [J].