Endoscopic treatment for esophago-gastric varices, current status in Japan.

BACKGROUND/AIMS: Endoscopic treatment for esophago-gastric varices is performed to save patients who suffer from bleeding. The purpose of this paper is to introduce the recent status in Japan and our original therapeutic measures and results.

MATERIALS AND METHODS

Japan's current status is discussed by our society's surveillant study and references. Our techniques' and results are also described through 214 patients which were treated by combination of endoscopic variceal ligation and sclerotherapy as well as 65 patients who underwent endoscopic injection sclerotherapy using histoacryl. Combination therapy is performed by endoscopic ligation and sclerotherapy using polidocanol and Histoacryl, without any contrast agent.

RESULTS

Combination therapy shaved a 97% eradicating effect which was as high as sclerotherapy alone (92%) and which required less therapeutic sessions than sclerotherapy. For actively bleeding patients, endoscopic ligation showed 100% hemostatic rate (29/29) while conventional sclerotherapy obtained 92% hemostasis (86/93). Histoacryl injection that were employed for uncontrollable bleeding from gastric varices and early recurrent bleeding of esophageal varices obtained 100% hemostatic rate.

CONCLUSIONS

Our original combination therapy was superior to either endoscopic ligation and sclerotherapy alone and histoacryl injection showed better results in hemostatic effect than conventional sclerotherapy without any complications.