Document Detail


Portal hemodynamics and clinical outcomes of patients with gastric varices after balloon-occluded retrograde transvenous obliteration.
MedLine Citation:
PMID:  20461439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Long-term hemodynamic effects and clinical outcomes after balloon-occluded retrograde transvenous obliteration (B-RTO) remain unclear. The purpose of this study was to evaluate long-term clinical results and effects on portal hemodynamics after B-RTO for the treatment of gastric varices with spontaneous gastrorenal shunt.
METHODS: A total of 21 patients with cirrhosis and gastric varices treated by B-RTO were evaluated. The cumulative survival rate was calculated, portal blood flow was measured by Doppler ultrasonography, and liver function was estimated on the basis of Child-Pugh classification before and 1 year after B-RTO.
RESULTS: Gastric varices disappeared or decreased markedly in size in all patients. Overall cumulative survival rates at 1, 3 and 5 years were 90.48, 71.11 and 53.71%, respectively. Portal blood flow increased significantly from 681.9 +/- 294.9 to 837.0 +/- 279.1 ml/min (P = 0.0125) after B-RTO. Child-Pugh score was not significantly changed (P = 0.755) after obliteration, but serum albumin was elevated significantly from 3.49 +/- 0.49 to 3.75 +/- 0.53 g/dl (P = 0.0459). The ascites score was significantly increased (P = 0.0455) after B-RTO, but all cases of ascites could be controlled with medication.
CONCLUSIONS: Balloon-occluded retrograde transvenous obliteration is a safe and effective treatment for gastric varices with gastrorenal shunt. Portal blood flow and serum albumin parameters are increased, and liver function is unchanged after B-RTO.
Authors:
Akiyoshi Kasuga; Hideaki Mizumoto; Shoichi Matsutani; Akitoshi Kobayashi; Tsunehiro Endo; Takeshi Ando; Seigo Yukisawa; Hitoshi Maruyama; Osamu Yokosuka
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-05-12
Journal Detail:
Title:  Journal of hepato-biliary-pancreatic sciences     Volume:  17     ISSN:  1868-6982     ISO Abbreviation:  J Hepatobiliary Pancreat Sci     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2011-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528587     Medline TA:  J Hepatobiliary Pancreat Sci     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  898-903     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Funabashi Municipal Medical Center, Chiba, Japan. akiyoshi_81@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Balloon Occlusion / methods*
Esophageal and Gastric Varices / mortality,  physiopathology,  therapy*
Female
Follow-Up Studies
Humans
Japan / epidemiology
Male
Middle Aged
Portal System / physiopathology*,  ultrasonography
Regional Blood Flow / physiology*
Retrospective Studies
Survival Rate / trends
Treatment Outcome
Ultrasonography, Doppler, Color

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


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