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Endoscopic treatment or balloon-occluded retrograde transvenous obliteration is safe for patients with esophageal/gastric varices in Child-Pugh class C end-stage liver cirrhosis
- Source :
- Clinical and Molecular Hepatology, Vol 25, Iss 2, Pp 183-189 (2019), Clinical and Molecular Hepatology
- Publication Year :
- 2019
- Publisher :
- The Korean Association for the Study of the Liver, 2019.
-
Abstract
- Background/Aims: There is a controversy about the availability of invasive treatment for esophageal/gastric varices in patients with Child-Pugh class C (CP-C) end-stage liver cirrhosis (LC). We have evaluated the validity of invasive treatment with CP-C end-stage LC patients. Methods: The study enrolled 51 patients with CP-C end-stage LC who had undergone invasive treatment. The treatment modalities included endoscopic variceal ligation in 22 patients, endoscopic injection sclerotherapy in 17 patients, and balloon-occluded retrograde transvenous obliteration (BRTO) in 12 patients. We have investigated the overall survival (OS) rates and risk factors that contributed to death within one year after treatment. Results: The OS rate in all patients at one, three, and five years was 72.6%, 30.2%, and 15.1%, respectively. The OS rate in patients who received endoscopic treatment and the BRTO group at one, three, and five years was 67.6%, 28.2% and 14.1% and 90.0%, 36.0% and 18.0%, respectively. The average of Child-Pugh scores (CPS) from before treatment to one month after variceal treatment significantly improved from 10.53 to 10.02 (P=0.003). Three significant factors that contributed to death within one year after treatment included the presence of bleeding varices, high CPS (≥11), and high serum total bilirubin levels (≥4.0 mg/dL). Conclusions: The study demonstrated that patients with a CPS of up to 10 and less than 4.0 mg/dL of serum total bilirubin levels may not have a negative impact on prognosis after invasive treatment for esophageal/gastric varices despite their CP-C end-stage LC. (Clin Mol Hepatol 2019;25:183-189)
- Subjects :
- Adult
Male
medicine.medical_specialty
Cirrhosis
Esophageal and gastric varices
medicine.medical_treatment
Severity of Illness Index
Gastroenterology
Endoscopy, Gastrointestinal
03 medical and health sciences
0302 clinical medicine
Risk Factors
Hemostasis, endoscopic
Internal medicine
medicine
Sclerotherapy
Humans
lcsh:RC799-869
Stage (cooking)
Portal hypertension
Molecular Biology
Aged
Hepatology
medicine.diagnostic_test
business.industry
Endoscopy
Middle Aged
Gastric varices
medicine.disease
Survival Rate
Editorial
Radiology, interventional
Balloon occlusion
030220 oncology & carcinogenesis
Liver cirrhosis
Female
lcsh:Diseases of the digestive system. Gastroenterology
030211 gastroenterology & hepatology
Child-Pugh Class C
Varices
business
Subjects
Details
- ISSN :
- 2287285X and 22872728
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Clinical and Molecular Hepatology
- Accession number :
- edsair.doi.dedup.....2d00a8cf0a0d34cc87dc53c02d7dfe22