Comparative Study Of The Efficacy Of Esophageal Gastric Variceal Bleeding With Endoscopic And Surgical Treatment

Objective:To evaluate the curative effects of esophageal gastric variceal bleeding therapy with endoscopic and surgical treatment.Materials and Methods:One hundred and sixty cases with esophageal gastric varices bleeding were treated respectively by interventional endoscopy only(endoscopic group,n=72) and devascularization combined with splenectomy(surgical group,n=88),compare emergency hemostasis rate,early rebleeding rate,delayed rebleeding rate,vein disappearance rate,and the mortality rate of two groups.Patient actuarial survival was determined by Kaplan-Meier analysis.The probable risk factors for early rebleeding after endoscopic treatment were analysed.Results The early rebleeding rate of endoscopic group is significantly higher than that of surgical group(37.5% vs 7.95%,P=0.000),while the delayed rebleeding rate is lower than surgical group(5.88% vs 21.95%,P=0.000),and the rate of vein disappearance is also higher than that of surgical group(70.83% vs 42.05%,p=0.001).Logistic regression analysis showed that the history of surgical treatment was a protective factor for early rebleeding after endoscopic treatment, while the maximum diameter of varicose vein was the risk factors of early rebleeding after endoscopic treatment.The mortality rate of experimental group is significantly higher than(that of surgical group)( 16.66% vs 4.55%, P=0.028), while no significant difference about long-term survival rate and emergency hemostasis rate( 98.61% vs96.59%,p=0.628)between two groups.Conclusion On the esophageal gastric varices bleeding of cirrhosis,the short-term effects of surgical group is better than endoscopic group.But the vein disappearance rateand the delayed bleeding rate of the endoscopic group were superior to the surgical group.There is no difference in the long-term survival rate between the endoscopic and surgical treatment in the patients.