Shibuya S, Takase Y, Chikamori F, Kawashima T, Sawano T
Department of Surgery, Tsukuba Memorial Hospital.
Wiad Lek. 1997;50 Suppl 1 Pt 1:293-5.
We have reported a 16.0 mm long new type of instrument with the inner diameter of inner cylinder of 10.3 mm for endoscopic variceal ligation which could shoot 3 elastic O bands continuously in short period of time without removing the endoscope. The suction volume of new instrument is larger than that of the Stiegmann's ligator. We performed endoscopic variceal ligation (EVL) in 17 cases of the esophageal varix and 8 cases of the solitary gastric varix. EVL was performed as prophylaxis as all the cases. The esophageal varices were eliminated in all the cases after ulcer formation. The procedure was performed one time in 15 cases and two times in the remaining 2 cases. Three patients died one to hepatic failure during the follow-up period between 4 and 16 months. Six and twelve months cumulative recurrence rates were 30% and 48% respectively. On the other hand all the gastric varices disappeared after one sitting of the treatment. There was one variceal recurrence during the follow-up period. Computed tomography and/or arterioportography performed before had showed patent gastro-renal shunt in five cases. No change in the shunt was observed after the treatment. No serious complications due to EVL was encountered in all the cases. Therefore, it is thought that this method can be used for the treatment of not only esophageal varices but also gastric varices.
我们报道了一种新型器械，长16.0毫米，内筒内径为10.3毫米，用于内镜下静脉曲张结扎术，该器械可在短时间内连续射出3个弹性O形环，无需移除内镜。新器械的吸量大于施蒂格曼结扎器。我们对17例食管静脉曲张患者和8例孤立性胃静脉曲张患者进行了内镜下静脉曲张结扎术（EVL）。所有病例均作为预防性治疗进行EVL。所有病例在溃疡形成后食管静脉曲张均消失。15例患者手术1次，其余2例手术2次。3例患者在4至16个月的随访期内因肝功能衰竭死亡。6个月和12个月的累积复发率分别为30%和48%。另一方面，所有胃静脉曲张在一次治疗后均消失。随访期间有1例静脉曲张复发。术前进行的计算机断层扫描和/或动脉门静脉造影显示5例患者存在胃肾分流。治疗后分流情况未见变化。所有病例均未出现因EVL导致的严重并发症。因此，认为该方法不仅可用于治疗食管静脉曲张，也可用于治疗胃静脉曲张。
