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