INDICATIONS AND RESULTANT EFFICACIES OF ENDOSCOPIC INJECTION SCLEROTHERAPY FOR ESOPHAGEAL AND GASTRIC VARICIES

The efficacy of endoscopic injection sclerotherapy (EIS) was studied in 126 patients who underwent treatment with EIS for esophageal and gastric varicies. A second EIS was performed in 15 of 38 patients without hemorrhage after palliative treatment for liver cirrhosis (LC) and idiopathic portal hypertension (IPH) and in seven of 32 patients without hemorrhage after palliative treatment for hepatoma (HCC), about eight months and nine months, respectively, after the initial EIS. Hemorrhage was observed in five (13%) patients with LC or IPH and 10(24%) with HCC, about eight months and three months, respectively, after EIS as palliative treatment. The incidences of emergency hemostasis were 92% and 73% for patients with LC and IPH and HCC, respectively. Some patients with hemorrhage or rehemorrhage showed specific hemodynamic changes. The necessity of additional EIS should therefore be evaluated by endoscopy every 3 to 6 months after EIS, simultaneously with detailed examination of portal hemodynamic changes. If necessary, other therapeutic methods should be used with EIS.