Endoscopic variceal ligation-injection sclerotherapy (EVLIS) for gastric varices: Analysis of 10 years' experience

Park, Chul Hee; Chun, Hoon Jai; Jeong, Rok Sun; Kim, Kyung Ho; Kim, Yong Sik; Kim, Young Sun; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Lee, Sang Woo; Choi, Jai Hyun; Kim, Chang Duck; Ryu, Ho Sang; Hyun, Jin Hai

Abstract

BACKGROUND: The aim of this study is to evaluate the long-term clinical outcome, rebleeding rate, and recurrence rate of endoscopic variceal ligation injection sclerotherapy (EVLIS) for gastric varices.
METHODS
302 cases were chosen from patients treated with EVLIS for gastric varices from September 1992 to August 2002. The follow-up period ranged from 6 to 12 months with average being 35 months.
RESULTS
The number of patients with gastric varices F1, F2, F3 were 105 (43.8%), 127 (42%), 70 (23.2%) and Lg-c, Lg-f, Lg-cf were 82 (26.9%), 67 (22.2%), 153 (50.9%). The average sessions of therapy needed for the initial hemostasis was 2.34 times. Initial hemostasis in 117 patients who needed emergency treatment was successfully done in all cases. Early rebleeding was observed in 36 (12%) patients in whom most of the bleeding occurred from the secondary ulcer. Late rebleeding was observed in 37 (12.2%) patients in whom secondary ulcer and gastric variceal bleeding accounted for rebleeding in 14 (4.6%) patients and 23 (7.6%) patients respectively. Within the follow-up period, recurrence of gastric varices was observed in 104 (34.3%) patients with the average time to recurrence being 18.8+/-16 months.
CONCLUSION
Since our method shows similar results with that of long-studied esophageal variceal therapy, it is thought of as an excellent treatment modality for gastric varices.