Effects of Endoscopic Variceal Sclerotherapy on Portohepatic Hemodynamics

Shin, Kyoung Deok; Lee, Jei Kyoung; Kim, Hyoung Sik; Kim, Dae Ghon; Ahn, Deuk Soo

Abstract

BACKGROUND/AIMS: We determined whether the portal hypertension in patients with esophageal varices would be changed hemodynamically after endoscopic injection sclerotherapy (EIS). Present study was performed to find out hemodynamic change of portal hypertension, the occurrence of new gastric varix and the disappearance of previous gastric varix after EIS.
METHODS
The doppler sonographic parameters including cross sectional area, velocity of flow, blood flow volume, and congestion index were used to measure the portal hemodynamic change between before and after EIS in 22 patients. Additionally, gastrofiberscopic examination was performed to determine the effects of EIS on gastric varix formation before and a year after EIS.
RESULTS
Four parameters of doppler ultrasound were not significantly changed between before and after EIS, while the blood flow volume increased. One cases (67%) revealed newly formed gastric varix, but 3 out of 7 cases (43%, p=0.022) in which the early endoscopic examination identified the presence of gastric varix showed a decrease of it.
CONCLUSIONS
In patients with esophageal varices, hemodynamics was not significantly changed after EIS. Moreover, gastric varix was not aggravated and even disappeared after EIS. Thus, EIS is supposed to be a positive therapeutic modality for treating esophageal varix.