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Sclerotherapy on liver cirrhosis with esophageal variceal bleeding: eight years of experience.
Zhonghua Yi Xue Za Zhi (Taipei). 1994 Nov; 54(5):321-8.ZY

Abstract

BACKGROUND

Patients with liver cirrhosis usually die of hepatic failure and variceal bleeding. Successful treatment of the latter can reduce mortality. Sclerotherapy is one method often used. This study compared (a) the successful rate of acute bleeding control; (b) short- and long-term survival rate between those with and without treatment with sclerotherapy to evaluate the clinical benefit of sclerotherapy for liver cirrhosis patients with esophageal variceal bleeding.

METHODS

Between August 1983 and December 1991, 183 cirrhotic patients with esophageal variceal bleeding receiving endoscopic injection sclerotherapy (EIS) was compared with 123 patients without sclerotherapy treatment retrospectively. The severity of underlying liver disease was classified using a modified Child's classification. Sclerotherapy was done within 48 hours after active bleeding in the sclerotherapy-treated group, while the medical treatment group received Sengstaken-Blakemore (SB) tube or pitressin infusion only.

RESULTS

Successful rate of acute bleeding control was 81.63% (120/147) in the EIS group and 59.35% (73/123) in the medical treatment group. The worse the hepatic function of the patients, the lower the success of acute bleeding control in both groups. Fifty subjects (74.63%) had varices eradicated in 67 sclerotherapy treatment patients with regular follow-up. Patients receiving EIS had a better long-term survival than those without treatment. Benefit of EIS on long-term survival was more significant in Child B patients and less in Child C and Child A patients. Death from variceal bleeding was lower in the EIS group than in the medical treatment group (32% vs 62.6%). Complications of EIS were rare. Eight patients died of aspiration pneumonia, spontaneous bacterial peritonitis or acute renal failure after sclerotherapy, and most were Child B and C patients. Sixteen patients had esophageal stricture. Four needed dilatation treatment.

CONCLUSIONS

The sclerotherapy-treated group had a higher control rate of acute bleeding and lower mortality rate from esophageal variceal bleeding compared with the medical-treated group. The procedure prolonged long-term survival in Child B patients but did so less frequently in Child A and Child C patients. The incidence of complications was low. As a whole, EIS is a safe and efficient method for control of esophageal variceal bleeding.

Authors+Show Affiliations

Department of Internal Medicine, Chung Shan Medical and Dental College Hospital, Taichung, Taiwan, R.O.C.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

7834554

Citation

Cheng, C Y., et al. "Sclerotherapy On Liver Cirrhosis With Esophageal Variceal Bleeding: Eight Years of Experience." Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed, vol. 54, no. 5, 1994, pp. 321-8.
Cheng CY, Chen GH, Chang CS, et al. Sclerotherapy on liver cirrhosis with esophageal variceal bleeding: eight years of experience. Zhonghua Yi Xue Za Zhi (Taipei). 1994;54(5):321-8.
Cheng, C. Y., Chen, G. H., Chang, C. S., Tseng, C. C., Chen, T. Y., Lin, C. K., Pan, H. K., Huang, C. K., Hsieh, P. F., & Huang, P. T. (1994). Sclerotherapy on liver cirrhosis with esophageal variceal bleeding: eight years of experience. Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed, 54(5), 321-8.
Cheng CY, et al. Sclerotherapy On Liver Cirrhosis With Esophageal Variceal Bleeding: Eight Years of Experience. Zhonghua Yi Xue Za Zhi (Taipei). 1994;54(5):321-8. PubMed PMID: 7834554.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sclerotherapy on liver cirrhosis with esophageal variceal bleeding: eight years of experience. AU - Cheng,C Y, AU - Chen,G H, AU - Chang,C S, AU - Tseng,C C, AU - Chen,T Y, AU - Lin,C K, AU - Pan,H K, AU - Huang,C K, AU - Hsieh,P F, AU - Huang,P T, PY - 1994/11/1/pubmed PY - 1994/11/1/medline PY - 1994/11/1/entrez SP - 321 EP - 8 JF - Zhonghua yi xue za zhi = Chinese medical journal; Free China ed JO - Zhonghua Yi Xue Za Zhi (Taipei) VL - 54 IS - 5 N2 - BACKGROUND: Patients with liver cirrhosis usually die of hepatic failure and variceal bleeding. Successful treatment of the latter can reduce mortality. Sclerotherapy is one method often used. This study compared (a) the successful rate of acute bleeding control; (b) short- and long-term survival rate between those with and without treatment with sclerotherapy to evaluate the clinical benefit of sclerotherapy for liver cirrhosis patients with esophageal variceal bleeding. METHODS: Between August 1983 and December 1991, 183 cirrhotic patients with esophageal variceal bleeding receiving endoscopic injection sclerotherapy (EIS) was compared with 123 patients without sclerotherapy treatment retrospectively. The severity of underlying liver disease was classified using a modified Child's classification. Sclerotherapy was done within 48 hours after active bleeding in the sclerotherapy-treated group, while the medical treatment group received Sengstaken-Blakemore (SB) tube or pitressin infusion only. RESULTS: Successful rate of acute bleeding control was 81.63% (120/147) in the EIS group and 59.35% (73/123) in the medical treatment group. The worse the hepatic function of the patients, the lower the success of acute bleeding control in both groups. Fifty subjects (74.63%) had varices eradicated in 67 sclerotherapy treatment patients with regular follow-up. Patients receiving EIS had a better long-term survival than those without treatment. Benefit of EIS on long-term survival was more significant in Child B patients and less in Child C and Child A patients. Death from variceal bleeding was lower in the EIS group than in the medical treatment group (32% vs 62.6%). Complications of EIS were rare. Eight patients died of aspiration pneumonia, spontaneous bacterial peritonitis or acute renal failure after sclerotherapy, and most were Child B and C patients. Sixteen patients had esophageal stricture. Four needed dilatation treatment. CONCLUSIONS: The sclerotherapy-treated group had a higher control rate of acute bleeding and lower mortality rate from esophageal variceal bleeding compared with the medical-treated group. The procedure prolonged long-term survival in Child B patients but did so less frequently in Child A and Child C patients. The incidence of complications was low. As a whole, EIS is a safe and efficient method for control of esophageal variceal bleeding. SN - 0578-1337 UR - https://www.unboundmedicine.com/medline/citation/7834554/Sclerotherapy_on_liver_cirrhosis_with_esophageal_variceal_bleeding:_eight_years_of_experience_ L2 - https://medlineplus.gov/cirrhosis.html DB - PRIME DP - Unbound Medicine ER -