Document Detail


Endoscopic therapy for bleeding esophageal varices improves the outcome of Child C cirrhotic patients.
MedLine Citation:
PMID:  16984593     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM: Bleeding from esophageal varices is one of the frequent severe complications arising in patients with liver cirrhosis. The management of esophageal varices is therefore important for patient survival. The purpose of this study was to clarify the predictive factors for mortality in patients with Child C cirrhosis presenting with variceal bleeding. METHODS: A retrospective analysis of 77 Child C cirrhotic patients with bleeding from esophageal varices was conducted. All patients received endoscopic therapy. Twenty-nine patients received endoscopic variceal ligation, and 48 patients received endoscopic injection sclerotherapy or endoscopic injection sclerotherapy with ligation. Univariate and multivariate analyses of clinical data were performed to identify the prognostic factors for survival for these 77 patients. RESULTS: Fifty-seven of 77 patients received endoscopic therapy within 24 h after variceal bleeding, and bleeding was controlled in 55 (96.5%). The remaining 20 patients received endoscopic therapy more than 24 h after bleeding. Higher bilirubin level and rebleeding were the predictive parameters for 6-week survival in the 77 patients, according to univariate and multivariate analysis. Higher bilirubin level, refractory ascites, and the presence of hepatocellular carcinoma were the predictive parameters for mortality in 77 patients as determined by multivariate analysis. CONCLUSIONS: Endoscopic therapy was effective in controlling acute variceal bleeding of Child C cirrhotic patients. The prognosis of Child C stage patients presenting with variceal bleeding depended on the severity of liver damage and the presence of hepatocellular carcinoma.
Authors:
Shinichiro Hori; Akinobu Takaki; Hiroyuki Okada; Akiko Fujiwara; Ryuta Takenaka; Chiho Makidono; Yasushi Shiratori
Related Documents :
17186393 - Paper-based dosing algorithms for maintenance of warfarin anticoagulation.
19432923 - Assessment of incidence of inhibitors in patients with haemophilia.
833993 - Emergency department staffing to improve patient management.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  21     ISSN:  0815-9319     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-09-20     Completed Date:  2007-01-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  1704-9     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Carcinoma, Hepatocellular / complications,  mortality
Esophageal and Gastric Varices / etiology,  mortality,  therapy*
Esophagoscopy*
Female
Gastrointestinal Hemorrhage / etiology,  mortality,  therapy*
Humans
Injections, Intralesional
Ligation
Liver Cirrhosis / complications*,  mortality
Liver Neoplasms / complications,  mortality
Male
Proportional Hazards Models
Sclerosing Solutions / administration & dosage
Sclerotherapy
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Sclerosing Solutions

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The Vienna classification applied to colorectal adenomas.
Next Document:  Estimation of standard liver volume in Japanese living liver donors.