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Portal hemodynamics and clinical outcomes of patients with gastric varices after balloon‐occluded retrograde transvenous obliteration
Author(s) -
Kasuga Akiyoshi,
Mizumoto Hideaki,
Matsutani Shoichi,
Kobayashi Akitoshi,
Endo Tsunehiro,
Ando Takeshi,
Yukisawa Seigo,
Maruyama Hitoshi,
Yokosuka Osamu
Publication year - 2010
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-010-0292-2
Subject(s) - ascites , gastric varices , medicine , varices , cirrhosis , gastroenterology , portal hypertension , liver function , hemodynamics , balloon , shunt (medical) , albumin , blood flow , portal venous pressure
Background Long‐term hemodynamic effects and clinical outcomes after balloon‐occluded retrograde transvenous obliteration (B‐RTO) remain unclear. The purpose of this study was to evaluate long‐term clinical results and effects on portal hemodynamics after B‐RTO for the treatment of gastric varices with spontaneous gastrorenal shunt. Methods A total of 21 patients with cirrhosis and gastric varices treated by B‐RTO were evaluated. The cumulative survival rate was calculated, portal blood flow was measured by Doppler ultrasonography, and liver function was estimated on the basis of Child‐Pugh classification before and 1 year after B‐RTO. Results Gastric varices disappeared or decreased markedly in size in all patients. Overall cumulative survival rates at 1, 3 and 5 years were 90.48, 71.11 and 53.71%, respectively. Portal blood flow increased significantly from 681.9 ± 294.9 to 837.0 ± 279.1 ml/min ( p = 0.0125) after B‐RTO. Child‐Pugh score was not significantly changed ( p = 0.755) after obliteration, but serum albumin was elevated significantly from 3.49 ± 0.49 to 3.75 ± 0.53 g/dl ( p = 0.0459). The ascites score was significantly increased ( p = 0.0455) after B‐RTO, but all cases of ascites could be controlled with medication. Conclusions Balloon‐occluded retrograde transvenous obliteration is a safe and effective treatment for gastric varices with gastrorenal shunt. Portal blood flow and serum albumin parameters are increased, and liver function is unchanged after B‐RTO.