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PREDICTION OF RECURRENCE AFTER ENDOSCOPIC TREATMENT FOR ESOPHAGEAL VARICES: WITH SPECIAL REFERENCE TO ESOPHAGEAL VARICEAL PRESSURE
Authors:Masaichi Ohira  Kazuhiko Yoshikawa  Takeshi Hori  Sadatoshi Shimizu  Yoshito Yamashita  Nobuya Yamada  Tetsuji Sawada  Hiroji Nishino  Michio Sowa  Kosei Hirakawa
Abstract:Background : We investigated the factors influencing esophageal variceal recurrence after endoscopic treatment on the basis of 25 variceal patients who were measured for esophageal variceal pressure, which had been reported to have a close relationship to variceal rupture. Method : Six patients (24.0%) showed variceal recurrence during follow‐up periods of up to 60 months. Clinical, biochemical, endoscopic and portal hemodynamic parameters were analyzed by univariate analysis in order to determine variceal recurrence. Results : The cumulative risk of variceal recurrence was greater in patients with F3 varices (P = 0.027), and esophageal variceal pressure (EVP) ≥ 15 mmHg (P = 0.021). It was not significantly related to any clinical, biochemical parameter. Large portosystemic collaterals, which were not concerned with esophageal varices, were demonstrated in five patients who had never showed variceal recurrence; all of their EVP were under 15 mmHg. Conclusion : It is suggested that the form of varices and EVP, which may reflect a part of portal hemodynamics, are the most reliable factors for predicting variceal recurrence.
Keywords:esophageal variceal pressure (EVP)  portal hemodynamics  variceal recurrence
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