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Oesophagogastric Varices (oesophagogastric + varices)

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Medical Sciences	100%

Selected Abstracts

Predicting the advent of ascites and other complications in primary biliary cirrhosis: a staged model approach

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2010
C.-W. CHAN
Aliment Pharmacol Ther,31, 573,582 Summary Background, Current survival models for primary biliary cirrhosis have limited precision for medium and long-term survival. Aim, To describe a prognostic model for the advent of complications in primary biliary cirrhosis as the first approach to a staged prognostic model. Methods, From an established database of 289 consecutive primary biliary cirrhosis patients referred to Royal Free Hospital over 12 years (mean follow-up of 4.1 years), baseline characteristics at referral were evaluated by Cox-proportional hazards regression modelling. Results, The following complications occurred de novo: 85 ascites/peripheral oedema, 40 oesophagogastric varices, 63 encephalopathy, 29 spontaneous bacterial peritonitis and/or septicaemia, 59 symptomatic urinary tract infections. Age, albumin, log10(bilirubin), presence of ascites at referral, variceal bleeding within 6 weeks before referral, detection of oesophagogastric varices at or before referral were significant at multivariate analysis with different combinations and coefficients for each complication. The model for predicting ascites and/or peripheral oedema best fitted the observed data (ROC = 0.7682, S.E. = 0.0385). Conclusions, The known prognostic factors in primary biliary cirrhosis also model the advent of complications. In view of the prognostic importance of ascites and its more robust statistical model, ascites and/or peripheral oedema could represent, following validation, the most suitable staged model in primary biliary cirrhosis to improve precision in survival modelling. [source]

Transvenous sclerotherapy for huge oesophagogastric varices using open injection sclerotherapy

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2000
Dr S. Kitano
Background The optimum procedure for long-term management of oesophagogastric varices when endoscopic sclerotherapy or ligation fails is yet to be established. This report describes a new procedure for treating huge oesophagogastric varices by open injection sclerotherapy. Methods Twenty-three patients with huge oesophagogastric varices underwent laparotomy and devascularization of the upper stomach with splenectomy. The left gastric vein was catheterized for repeated injection of 5 per cent ethanolamine oleate during the postoperative period. Results In all patients, the varices were eradicated after a mean of 3 sessions of sclerotherapy. There were no deaths or major complications during the mean follow-up period of 41 months. Small recurring varices in two patients were treated successfully by endoscopic sclerotherapy and interventional radiology. Conclusion Open injection sclerotherapy is an effective and safe procedure for the treatment of huge oesophagogastric varices. © 2000 British Journal of Surgery Society Ltd [source]