胃静脈りゅう治療の現況―胃静脈りゅう治療法―

DOI 被引用文献3件 参考文献8件

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  • ENDOSCOPIC TREATMENT OF GASTRIC VARICES

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Massive hemorrhage from gastric varices (GV) can often be fatal and requires immediate attention. Prediction of GV hemorrhage is difficult. However, aggressive treatment should be undertaken to prevent possible hemorrhage, i. e., large varices of F2 or F3, or GV with erosion and/or red color sign. It is widely accepted that infusion of a tissue adhesive (a -cyanoacrylate monomer (CA) or Histoacryl) should be the first-line treatment for gastric variceal bleeding. However, since the risk of re-bleeding is high due to the complex portal hemodynamics of GV, elective treatment after the bleeding has been stopped is very important. The combined method using CA and ethanolamine oleate (EO) is effective for this purpose. Moreover, CA-EO combined method followed by mucosa-f ibrosing using argon plasma coagulation is more effective to prevent re -bleeding from GV. Pre-treatment assessment of portal vein hemodynamics by endoscopic ultrasonography and multi-detector-row CT, and post-treatment assessment of the effect of treatment are important for safe and effective treatment using these methods.

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