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PREDICTION OF RECURRENCE AFTER ENDOSCOPIC TREATMENT FOR ESOPHAGEAL VARICES: WITH SPECIAL REFERENCE TO ESOPHAGEAL VARICEAL PRESSURE
Author(s) -
Ohira Masaichi,
Yoshikawa Kazuhiko,
Hori Takeshi,
Shimizu Sadatoshi,
Yamashita Yoshito,
Yamada Nobuya,
Sawada Tetsuji,
Nishino Hiroji,
Sowa Michio,
Hirakawa Kosei
Publication year - 2000
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1046/j.1443-1661.2000.00027.x
Subject(s) - medicine , esophageal varices , gastroenterology , varices , portal hypertension , portal venous pressure , hemodynamics , univariate analysis , cirrhosis , multivariate analysis
Background : We investigated the factors influencing esophageal variceal recurrence after endoscopic treatment on the basis of 25 variceal patients who were measured for esophageal variceal pressure, which had been reported to have a close relationship to variceal rupture. Method : Six patients (24.0%) showed variceal recurrence during follow‐up periods of up to 60 months. Clinical, biochemical, endoscopic and portal hemodynamic parameters were analyzed by univariate analysis in order to determine variceal recurrence. Results : The cumulative risk of variceal recurrence was greater in patients with F3 varices ( P = 0.027), and esophageal variceal pressure (EVP) ≥ 15 mmHg ( P = 0.021). It was not significantly related to any clinical, biochemical parameter. Large portosystemic collaterals, which were not concerned with esophageal varices, were demonstrated in five patients who had never showed variceal recurrence; all of their EVP were under 15 mmHg. Conclusion : It is suggested that the form of varices and EVP, which may reflect a part of portal hemodynamics, are the most reliable factors for predicting variceal recurrence.