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Endoscopic therapy for bleeding esophageal varices improves the outcome of Child C cirrhotic patients.
J Gastroenterol Hepatol. 2006 Nov; 21(11):1704-9.JG

Abstract

BACKGROUND AND AIM

Bleeding from esophageal varices is one of the frequent severe complications arising in patients with liver cirrhosis. The management of esophageal varices is therefore important for patient survival. The purpose of this study was to clarify the predictive factors for mortality in patients with Child C cirrhosis presenting with variceal bleeding.

METHODS

A retrospective analysis of 77 Child C cirrhotic patients with bleeding from esophageal varices was conducted. All patients received endoscopic therapy. Twenty-nine patients received endoscopic variceal ligation, and 48 patients received endoscopic injection sclerotherapy or endoscopic injection sclerotherapy with ligation. Univariate and multivariate analyses of clinical data were performed to identify the prognostic factors for survival for these 77 patients.

RESULTS

Fifty-seven of 77 patients received endoscopic therapy within 24 h after variceal bleeding, and bleeding was controlled in 55 (96.5%). The remaining 20 patients received endoscopic therapy more than 24 h after bleeding. Higher bilirubin level and rebleeding were the predictive parameters for 6-week survival in the 77 patients, according to univariate and multivariate analysis. Higher bilirubin level, refractory ascites, and the presence of hepatocellular carcinoma were the predictive parameters for mortality in 77 patients as determined by multivariate analysis.

CONCLUSIONS

Endoscopic therapy was effective in controlling acute variceal bleeding of Child C cirrhotic patients. The prognosis of Child C stage patients presenting with variceal bleeding depended on the severity of liver damage and the presence of hepatocellular carcinoma.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16984593

Citation

Hori, Shinichiro, et al. "Endoscopic Therapy for Bleeding Esophageal Varices Improves the Outcome of Child C Cirrhotic Patients." Journal of Gastroenterology and Hepatology, vol. 21, no. 11, 2006, pp. 1704-9.
Hori S, Takaki A, Okada H, et al. Endoscopic therapy for bleeding esophageal varices improves the outcome of Child C cirrhotic patients. J Gastroenterol Hepatol. 2006;21(11):1704-9.
Hori, S., Takaki, A., Okada, H., Fujiwara, A., Takenaka, R., Makidono, C., & Shiratori, Y. (2006). Endoscopic therapy for bleeding esophageal varices improves the outcome of Child C cirrhotic patients. Journal of Gastroenterology and Hepatology, 21(11), 1704-9.
Hori S, et al. Endoscopic Therapy for Bleeding Esophageal Varices Improves the Outcome of Child C Cirrhotic Patients. J Gastroenterol Hepatol. 2006;21(11):1704-9. PubMed PMID: 16984593.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic therapy for bleeding esophageal varices improves the outcome of Child C cirrhotic patients. AU - Hori,Shinichiro, AU - Takaki,Akinobu, AU - Okada,Hiroyuki, AU - Fujiwara,Akiko, AU - Takenaka,Ryuta, AU - Makidono,Chiho, AU - Shiratori,Yasushi, PY - 2006/9/21/pubmed PY - 2007/1/31/medline PY - 2006/9/21/entrez SP - 1704 EP - 9 JF - Journal of gastroenterology and hepatology JO - J Gastroenterol Hepatol VL - 21 IS - 11 N2 - BACKGROUND AND AIM: Bleeding from esophageal varices is one of the frequent severe complications arising in patients with liver cirrhosis. The management of esophageal varices is therefore important for patient survival. The purpose of this study was to clarify the predictive factors for mortality in patients with Child C cirrhosis presenting with variceal bleeding. METHODS: A retrospective analysis of 77 Child C cirrhotic patients with bleeding from esophageal varices was conducted. All patients received endoscopic therapy. Twenty-nine patients received endoscopic variceal ligation, and 48 patients received endoscopic injection sclerotherapy or endoscopic injection sclerotherapy with ligation. Univariate and multivariate analyses of clinical data were performed to identify the prognostic factors for survival for these 77 patients. RESULTS: Fifty-seven of 77 patients received endoscopic therapy within 24 h after variceal bleeding, and bleeding was controlled in 55 (96.5%). The remaining 20 patients received endoscopic therapy more than 24 h after bleeding. Higher bilirubin level and rebleeding were the predictive parameters for 6-week survival in the 77 patients, according to univariate and multivariate analysis. Higher bilirubin level, refractory ascites, and the presence of hepatocellular carcinoma were the predictive parameters for mortality in 77 patients as determined by multivariate analysis. CONCLUSIONS: Endoscopic therapy was effective in controlling acute variceal bleeding of Child C cirrhotic patients. The prognosis of Child C stage patients presenting with variceal bleeding depended on the severity of liver damage and the presence of hepatocellular carcinoma. SN - 0815-9319 UR - https://www.unboundmedicine.com/medline/citation/16984593/Endoscopic_therapy_for_bleeding_esophageal_varices_improves_the_outcome_of_Child_C_cirrhotic_patients_ L2 - https://doi.org/10.1111/j.1440-1746.2006.04267.x DB - PRIME DP - Unbound Medicine ER -