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Short-term portal hemodynamic effects of endoscopic embolization for esophageal varices.
Dig Surg. 2000; 17(5):454-8.DS

Abstract

BACKGROUND/AIM

Endoscopic embolization (EE) is a specialized treatment that obliterates esophageal varices along with their associated blood supply. The purpose of this study was to investigate the short-term effects of EE for esophageal varices on portal hemodynamics and liver function.

METHODS

Thirty patients with esophageal varices were included in this study. The portal blood flow was measured by an ultrasonic duplex Doppler system before and after EE. EE was performed by freehand intravariceal injection of 5% ethanolamine oleate with iopamidol with the aid of a balloon attached to the tip of an endoscope under fluoroscopy.

RESULTS

For the blood supply system, endoscopic varicography at the time of EE was able to show the vessels of the cardiac branch of the left gastric vein in 93% of the cases, the cardiac venous plexus in 90%, the trunk of the left gastric vein in 27%, the lesser curvature branch of the left gastric vein in 10%, the fundic branch of the short gastric vein in 13%, and the posterior gastric vein in 13%. For the blood drainage system, endoscopic varicography was able to show the paraesophageal vein in 39% of the cases, the inferior phrenic vein in 17%, and the mediastinal vein in 13%. No clotting was detected after EE in the intra- and extraportal veins in any of the cases. The flow velocities in the main portal vein before and after EE were 14.2+/-3.2 and 15.5+/-3.5 cm/s, respectively, showing no significant change. The cross-sectional area of the portal vein before and after EE was 0.96+/-0.21 and 1.04+/-0.23 cm(2), and the flow volume of the portal vein was 817+/-288 and 930+/-189 ml/min, both also showing no significant change. The blood laboratory parameters showed no significant change after EE.

CONCLUSIONS

We conclude that neither portal blood flow nor liver function were damaged by EE, although both the varices and their associated blood supply were obliterated.

Authors+Show Affiliations

Department of Surgery, Kuniyoshi Hospital, Kochi, Japan. chikamor@i-kochi.or.jpNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11124548

Citation

Chikamori, F, et al. "Short-term Portal Hemodynamic Effects of Endoscopic Embolization for Esophageal Varices." Digestive Surgery, vol. 17, no. 5, 2000, pp. 454-8.
Chikamori F, Kuniyoshi N, Shibuya S, et al. Short-term portal hemodynamic effects of endoscopic embolization for esophageal varices. Dig Surg. 2000;17(5):454-8.
Chikamori, F., Kuniyoshi, N., Shibuya, S., & Takase, Y. (2000). Short-term portal hemodynamic effects of endoscopic embolization for esophageal varices. Digestive Surgery, 17(5), 454-8.
Chikamori F, et al. Short-term Portal Hemodynamic Effects of Endoscopic Embolization for Esophageal Varices. Dig Surg. 2000;17(5):454-8. PubMed PMID: 11124548.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short-term portal hemodynamic effects of endoscopic embolization for esophageal varices. AU - Chikamori,F, AU - Kuniyoshi,N, AU - Shibuya,S, AU - Takase,Y, PY - 2000/12/22/pubmed PY - 2001/3/17/medline PY - 2000/12/22/entrez SP - 454 EP - 8 JF - Digestive surgery JO - Dig Surg VL - 17 IS - 5 N2 - BACKGROUND/AIM: Endoscopic embolization (EE) is a specialized treatment that obliterates esophageal varices along with their associated blood supply. The purpose of this study was to investigate the short-term effects of EE for esophageal varices on portal hemodynamics and liver function. METHODS: Thirty patients with esophageal varices were included in this study. The portal blood flow was measured by an ultrasonic duplex Doppler system before and after EE. EE was performed by freehand intravariceal injection of 5% ethanolamine oleate with iopamidol with the aid of a balloon attached to the tip of an endoscope under fluoroscopy. RESULTS: For the blood supply system, endoscopic varicography at the time of EE was able to show the vessels of the cardiac branch of the left gastric vein in 93% of the cases, the cardiac venous plexus in 90%, the trunk of the left gastric vein in 27%, the lesser curvature branch of the left gastric vein in 10%, the fundic branch of the short gastric vein in 13%, and the posterior gastric vein in 13%. For the blood drainage system, endoscopic varicography was able to show the paraesophageal vein in 39% of the cases, the inferior phrenic vein in 17%, and the mediastinal vein in 13%. No clotting was detected after EE in the intra- and extraportal veins in any of the cases. The flow velocities in the main portal vein before and after EE were 14.2+/-3.2 and 15.5+/-3.5 cm/s, respectively, showing no significant change. The cross-sectional area of the portal vein before and after EE was 0.96+/-0.21 and 1.04+/-0.23 cm(2), and the flow volume of the portal vein was 817+/-288 and 930+/-189 ml/min, both also showing no significant change. The blood laboratory parameters showed no significant change after EE. CONCLUSIONS: We conclude that neither portal blood flow nor liver function were damaged by EE, although both the varices and their associated blood supply were obliterated. SN - 0253-4886 UR - https://www.unboundmedicine.com/medline/citation/11124548/Short_term_portal_hemodynamic_effects_of_endoscopic_embolization_for_esophageal_varices_ L2 - https://www.karger.com?DOI=10.1159/000051940 DB - PRIME DP - Unbound Medicine ER -