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Prevention of variceal recurrence, bleeding, and death in cirrhosis patients with hypersplenism, especially those with severe thrombocytopenia.
Hepatogastroenterology. 2003 Nov-Dec; 50(54):1766-9.H

Abstract

BACKGROUND/AIMS

We investigated the impact of different treatments on the prognosis of cirrhosis patients with esophageal varices and thrombocytopenia.

METHODOLOGY

This prospective study enrolled 52 cirrhosis patients with esophageal varices and hypersplenism (platelet count < 50,000/mm3). In 26 patients, endoscopic variceal ligation plus partial splenic embolization were performed, while endoscopic variceal ligation alone was done in 26 patients. Endoscopic variceal ligation was repeated until complete eradication of varices was achieved. Partial splenic embolization was performed using the Seldinger method and embolic material was injected until a 60% to 80% reduction of splenic blood flow was achieved. The primary endpoints during the follow-up period included recurrence of varices, variceal bleeding, and death.

RESULTS

Comparison of endoscopic variceal ligation plus partial splenic embolization with endoscopic variceal ligation alone by multivariate analysis showed a relative risk ratio of 0.390 (95% CI [0.178-0.854]; p = 0.024) for new varices, 0.191 (95% CI [0.047-0.780]; p = 0.021) for variceal bleeding, and 0.193 (95% CI [0.053-0.699]; p = 0.012) for death.

CONCLUSIONS

These results suggest that endoscopic variceal ligation plus partial splenic embolization can prevent variceal recurrence, bleeding, and death in cirrhosis patients with esophageal varices and thrombocytopenia.

Authors+Show Affiliations

Division of Hepatology, Department of Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan. ohmotok@med.kawasaki-m.ac.jpNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

14696400

Citation

Ohmoto, Kenji, and Shinichiro Yamamoto. "Prevention of Variceal Recurrence, Bleeding, and Death in Cirrhosis Patients With Hypersplenism, Especially Those With Severe Thrombocytopenia." Hepato-gastroenterology, vol. 50, no. 54, 2003, pp. 1766-9.
Ohmoto K, Yamamoto S. Prevention of variceal recurrence, bleeding, and death in cirrhosis patients with hypersplenism, especially those with severe thrombocytopenia. Hepatogastroenterology. 2003;50(54):1766-9.
Ohmoto, K., & Yamamoto, S. (2003). Prevention of variceal recurrence, bleeding, and death in cirrhosis patients with hypersplenism, especially those with severe thrombocytopenia. Hepato-gastroenterology, 50(54), 1766-9.
Ohmoto K, Yamamoto S. Prevention of Variceal Recurrence, Bleeding, and Death in Cirrhosis Patients With Hypersplenism, Especially Those With Severe Thrombocytopenia. Hepatogastroenterology. 2003 Nov-Dec;50(54):1766-9. PubMed PMID: 14696400.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of variceal recurrence, bleeding, and death in cirrhosis patients with hypersplenism, especially those with severe thrombocytopenia. AU - Ohmoto,Kenji, AU - Yamamoto,Shinichiro, PY - 2003/12/31/pubmed PY - 2004/6/16/medline PY - 2003/12/31/entrez SP - 1766 EP - 9 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 50 IS - 54 N2 - BACKGROUND/AIMS: We investigated the impact of different treatments on the prognosis of cirrhosis patients with esophageal varices and thrombocytopenia. METHODOLOGY: This prospective study enrolled 52 cirrhosis patients with esophageal varices and hypersplenism (platelet count < 50,000/mm3). In 26 patients, endoscopic variceal ligation plus partial splenic embolization were performed, while endoscopic variceal ligation alone was done in 26 patients. Endoscopic variceal ligation was repeated until complete eradication of varices was achieved. Partial splenic embolization was performed using the Seldinger method and embolic material was injected until a 60% to 80% reduction of splenic blood flow was achieved. The primary endpoints during the follow-up period included recurrence of varices, variceal bleeding, and death. RESULTS: Comparison of endoscopic variceal ligation plus partial splenic embolization with endoscopic variceal ligation alone by multivariate analysis showed a relative risk ratio of 0.390 (95% CI [0.178-0.854]; p = 0.024) for new varices, 0.191 (95% CI [0.047-0.780]; p = 0.021) for variceal bleeding, and 0.193 (95% CI [0.053-0.699]; p = 0.012) for death. CONCLUSIONS: These results suggest that endoscopic variceal ligation plus partial splenic embolization can prevent variceal recurrence, bleeding, and death in cirrhosis patients with esophageal varices and thrombocytopenia. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/14696400/Prevention_of_variceal_recurrence_bleeding_and_death_in_cirrhosis_patients_with_hypersplenism_especially_those_with_severe_thrombocytopenia_ L2 - https://medlineplus.gov/cirrhosis.html DB - PRIME DP - Unbound Medicine ER -