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内镜超声引导下套扎联合硬化剂治疗孤立性胃静脉曲张:可行性、安全性和长期随访的病例系列研究。

Endoscopic ultrasound-guided coil deployment with sclerotherapy for isolated gastric varices: Case series of feasibility, safety, and long-term follow-up.

机构信息

Department of Gastroenterology, Dokkyo Medical University School of Medicine, Tochigi, Japan.

Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan.

出版信息

Dig Endosc. 2020 Nov;32(7):1100-1104. doi: 10.1111/den.13666. Epub 2020 May 12.

Abstract

The purpose of the present study is to report our experience of endoscopic ultrasound-guided coil deployment with sclerotherapy (EUS-CS) for isolated gastric varices (IGV) through a case series. Eight consecutive patients who had risky IGV were prospectively enrolled. EUS-CS was performed according to the following procedures: (i) several coils were first deployed in the IGV under EUS guidance; (ii) contrast medium was subsequently injected without removing the needle; (iii) if the infused contrast medium stayed in the IGV and feeding vein, sclerosant was then injected to obliterate the IGV and feeders. Coil deployment in the IGV was successfully performed in all cases. Sclerosant was injected both into the IGV and feeders in seven patients (87.5%). There was no adverse event during the procedure. During a median follow-up of 57 months, one patient who could not inject the sclerosant into IGV and feeders had an early hemorrhagic recurrence. Our case series showed that EUS-CS could be a feasible and safe procedure for the treatment of IGV.

摘要

本研究旨在通过病例系列报告我们在孤立性胃静脉曲张(IGV)内镜超声引导下线圈部署联合硬化治疗(EUS-CS)的经验。连续纳入了 8 例具有高危 IGV 的患者。EUS-CS 按照以下程序进行:(i)在 EUS 引导下首先在 IGV 中部署几个线圈;(ii)随后在不拔出针的情况下注入对比剂;(iii)如果注入的对比剂停留在 IGV 和供血静脉中,则注入硬化剂以闭塞 IGV 和供血静脉。所有病例均成功地在 IGV 中进行了线圈部署。在 7 例患者(87.5%)中,将硬化剂注入了 IGV 和供血静脉中。在手术过程中没有发生不良事件。在中位随访 57 个月期间,1 例不能将硬化剂注入 IGV 和供血静脉的患者出现早期出血复发。我们的病例系列表明,EUS-CS 可能是治疗 IGV 的一种可行且安全的方法。

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