内視鏡的硬化療法後再発静脈瘤の治療戦略

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  • Strategy for Treating Recurrent Varices after the Endoscopic Injection Sclerotherapy

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To improve the treatment of recurrent esophageal varices following endoscopic injection sclerotherapy (EIS), we visualized collaterals that supply blood to the varices by endoscopic varicealography during EIS (EVIS). Of 40 patients who required additive EIS for recurrent esophageal varices, 24 shows “good” EVIS giving clear collateral images, whereas the remaining 16 showed “poor” EVIS producing unclear collateral images on EVIS performed before additive EIS. Therapeutic results were marked improvement in 20, moderate improvement in 2, and no improvement in 2 of the 24 cases of “good” EVIS images, whereas they were 4, 8 and 4 in the 16 “poor” image cases, respectively. These results indicate that the usefulness of additive EIS is dependent on clear visualization of collaterals on EVIS that enables complete EIS.

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