Improved prognosis of cirrhosis patients with esophageal varices and thrombocytopenia treated by endoscopic variceal ligation plus partial splenic embolization

The aim of this study was to assess the efficacy of the combination of endoscopic variceal ligation (EVL) and partial splenic embolization (PSE) compared with EVL alone in cirrhosis patients with thrombocytopenia. In a prospective study, 84 cirrhosis patients with esophageal varices and thrombocytop...

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Published in:Digestive diseases and sciences 2006-02, Vol.51 (2), p.352-358
Main Authors: OHMOTO, Kenji, YOSHIOKA, Naoko, TOMIYAMA, Yasuyuki, SHIBATA, Norikuni, TAKESUE, Michihiko, YOSHIDA, Koji, KUBOKI, Makoto, YAMAMOTO, Shinichiro
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Embolization, Therapeutic
Endoscopy
Esophageal and Gastric Varices - complications
Esophageal and Gastric Varices - surgery
Feeding. Feeding behavior
Female
Follow-Up Studies
Fundamental and applied biological sciences. Psychology
Gastroenterology. Liver. Pancreas. Abdomen
Hematologic and hematopoietic diseases
Humans
Hypersplenism - complications
Hypersplenism - therapy
Ligation
Liver Cirrhosis - complications
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
Other diseases. Semiology
Platelet diseases and coagulopathies
Prospective Studies
Thrombocytopenia - complications
Treatment Outcome
Vertebrates: anatomy and physiology, studies on body, several organs or systems
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Summary:The aim of this study was to assess the efficacy of the combination of endoscopic variceal ligation (EVL) and partial splenic embolization (PSE) compared with EVL alone in cirrhosis patients with thrombocytopenia. In a prospective study, 84 cirrhosis patients with esophageal varices and thrombocytopenia (platelet count < 50,000/mm(3)) underwent EVL plus PSE (N = 42) or EVL alone (N = 42). Primary end points assessed during the follow-up period included the recurrence of varices, progression to variceal bleeding, and death. Comparison between combined treatment and variceal ligation alone by multivariate analysis showed a hazard ratio of 0.44 for the recurrence of varices (P = 0.02), 0.19 for progression to variceal bleeding (P = 0.01), and 0.31 for death (P = 0.04). These results suggest that the combination of EVL plus PSE can prevent the recurrence of varices, progression to variceal bleeding, and death in cirrhosis patients with esophageal varices and thrombocytopenia.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-006-3137-8