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经皮经肝食管胃底静脉曲张栓塞相关操作治疗孤立性胃静脉曲张:三例经验。

Percutaneous transhepatic obliteration-related procedures for isolated gastric varices: experience of three cases.

机构信息

Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.

Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.

出版信息

Clin J Gastroenterol. 2022 Feb;15(1):192-198. doi: 10.1007/s12328-021-01548-7. Epub 2021 Nov 11.

Abstract

Percutaneous transhepatic obliteration (PTO) can facilitate antegrade embolization of variceal veins. We herein report three patients who underwent percutaneous transhepatic sclerotherapy (PTS) or percutaneous transportal outflow-vessel-occluded sclerotherapy (PTOS) for isolated gastric varices. PTS was performed in Cases 1 and 2, and PTOS was performed in Case 3. Technical success was achieved in all patients without a decline in liver function; however, lack of a therapeutic benefit with rupture of esophageal varices occurred in Case 3. Case 3 had a history of pylorus gastrectomy plus Billroth-I reconstruction for gastric cancer and multiple feeding veins existed. PTO-related procedures are good treatment options for isolated gastric varices, but clinicians should be aware of the risk of treatment failure, especially the cases which have multiple feeding veins.

摘要

经皮经肝闭塞术(PTO)可促进静脉曲张的顺行栓塞。我们在此报告 3 例因孤立性胃静脉曲张而行经皮经肝硬化治疗(PTS)或经皮经门腔静脉流出道闭塞性硬化治疗(PTOS)的患者。在病例 1 和 2 中进行了 PTS,在病例 3 中进行了 PTOS。所有患者均成功实现了技术上的成功,而肝功能没有下降;然而,在病例 3 中,食管静脉曲张破裂并未带来治疗效果。病例 3 有因胃癌行幽门胃切除术和毕式 I 式重建的病史,并且存在多条供养静脉。PTO 相关的手术是治疗孤立性胃静脉曲张的一种很好的选择,但临床医生应注意治疗失败的风险,特别是存在多条供养静脉的情况。

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