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Accession number;03A0080119
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| Title;Analysis of Portal Hemodynamics in Long-Term Recurrence-Free Patients after Endoscopic Variceal Ligation (EVL): Evaluation with Endoscopic Ultrasonography. |
| Author;
OIKAWA KEISUKE
(Sendaikoseibyoin Shokakinaika)
OHARA SHUICHI
(Tohokudai Shokakibyotaigaku)
SUGIYAMA KOICHI
(Sendaishibyoin Shokakika)
SEKINE HITOSHI
(Tohokudai Shokakibyotaigaku)
KOIKE TOMOYUKI
(Tohokudai Shokakibyotaigaku)
KITAGAWA YASUSHI
(Tohokudai Shokakibyotaigaku)
SHIMOSEGAWA TOORU
(Tohokudai Shokakibyotaigaku)
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Journal Title;Gastroenterol Endosc
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Journal Code:G0608B
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ISSN:0387-1207
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VOL.45;NO.1;PAGE.3-11(2003)
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| Figure&Table&Reference;FIG.12, TBL.2, REF.25 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Background and Aims: Endoscopic variceal ligation (EVL) is superior to endoscopic injection sclerotherapy (EIS) with respect to the simplicity and safety. However, indication of EVL should be carefully determined because long-term effectiveness of EVL remains controversial, though a small number of patients are experienced to be free from recurrence after EVL. The relationship between the findings on endoscopic ultrasonography (EUS) and recurrence rate was studied to elucidate the portal hemodynamics in long-term recurrence-free patients after EVL. Materials and Methods: The subjects consisted of 22 patients who were followed-up for more than 2 years after EVL. EUS observation of hemodynamics was performed at the paraesophageal vein (PEV), extragastric vein (EGV) and esophageal perforating vein (EPV). PEV consititutes collateral blood flow in the esophageal outer wall. EGV is located in the lesser curvature of the cardia as a direct inflow route for the blood supply to the esophagogastric varices. EPV penetrates the esophageal wall to connect outer and inner blood flows. Analyses were performed on the relationships (1) between the size of PEV and EGV before EVL and the recurrence rate, (2) between the visibility of EPV and the recurrence rate, and (3) between the visibility of EPV and the change in the size of PEV after EVL. Results: (1) The recurrence rate was significantly higher (p < 0.01) in the patients with more dilated EGV before EVL on EUS. In contrast, no significant relationship was noted between the dilatation of PEV and the recurrence rate. (2) The 2-year recurrence rate was 93.8% in the patients with visible EPV, which was significantly higher (p < 0.05) than that in the patients without visible EPV (50%). Excluding patients with severe dilatation of EGV, varices recurred in 11 of 12 patients (91.7%) with visible EPV. In contrast, no recurrence was noted for more than 2 years after EVL in 3 patients without visible EPV.... (author abst.) |
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