Endoscopic hemostasis in patients with portal hypertension tumor genesis

AIM OF THE STUDY: to assess the results of using endoscopic techniques to achieve hemostasis for the control of bleeding and the prevention of recurrent bleeding from esophageal and gastric varices in the patients with primary liver cancer and metastatic liver lesions. MATERIALS AND METHODS: in the period of 2009-2011,7 patients with primary liver cancer or metastatic liver lesions complicated by gastro-esophageal bleeding were treated in the Sklifosovsky Clinical and Research Institute for Emergency Medicine. The sources of bleeding were esophageal varices in 6 patients, gastric varices in 1. RESULTS: a diagnostic esophagogastroduodenoscopy (EGDS) revealed, besides the varices, an erosive hemorrhagic gastritis in 4 patients, a ruptured mucosa of cardio-esophageal transition in 1, an erosive hemorrhagic gastritis and a liver tumour invasion in the stomach antrum in 1. The hemostasis achieved by means of paravasal injections with a 20% glucose solution was efficient in 2 of 3 patients. The endoscopic ligations of esophageal varices were performed in 3 patients. Five patients died from the underlying disease progressing. In one of them, the cause of death was a recurrent bleeding from esophageal varices. CONCLUSIONS: in the patients with primary liver cancer and metastatic liver lesions, the use of mini-invasive endoscopic techniques is more appropriate, because the surgical treatment of this patient population carries a very high risk.