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Endoscopic Variceal Injection Sclerotherapy for Liver Cirrhosis with Hepatocellular Carcinoma—A Prognostic Evaluation—
Author(s) -
ISHIDA Motoo,
MASUYAMA Hironori,
SUZUKI Takuji,
EBIHARA Tetsuro,
UENO Akihiko,
KATOH Yoshihisa,
HARADA Takashi
Publication year - 1990
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 - 10.1111/j.1443-1661.1990.tb00052.x
Subject(s) - medicine , sclerotherapy , cirrhosis , hepatocellular carcinoma , gastroenterology , varices , esophageal varices , survival rate , mortality rate , surgery , portal hypertension
The prognostic evaluation of endoscopic injection sclerotherapy (EIS) for patients with severe esophageal varices in unresectable hepatocellular carcinoma complicated with advanced liver cirrhosis (HCC c̄ LC) was studied. (1) Cumulative survival rate and cause of death were compared in cases of variceal bleeding managed by EIS (18 cases) to cases with variceal bleeding without EIS (12 cases). (2) Cumulative percentage of patients free of bleeding, cumulative survival rate and cause of death were compared in cases managed by prophylactic EIS (14 cases) to cases without prophylactic EIS (30 cases). In the two bleeding groups with and without EIS, and in the non‐bleeding groups with and without prophylactic EIS, patients of each group were comparable in respect to sex ratio, age, and Child's classification. In the bleeding groups, cumulative survival rate at 30 days after EIS was significantly higher in cases with EIS than cases without EIS (P < 0.01). The rate of death after initial bleeding was 16. 7% in cases with EIS and 66.7% in cases without EIS: statistical significance was demonstrated in these two groups (P < 0.01). In the non‐bleeding groups, cumulative percentage of patients free of bleeding and cumulative survival rate were significantly higher in cases with EIS than those without EIS (P < 0.01 and P < 0.05, respectively). Furthermore, no bleeding fatalities from varices were seen in cases with prophylactic EIS. We suggest that EIS improves survival rate and prophylactic EIS prevents variceal bleeding leading to death in cases of unresectable HCC c̄ LC.