A Retrospective Study Of Esophageal Variceal Band Ligation Versus Esophageal And Gastric Variceal Band Ligation In The Management Of Bleeding Gastric Varices

ObjectiveThe purpose of the thesis was to assess the efficacy of the treatment of gastric varices(GV), which contained esophageal and gastric variceal band ligation(EGVL), Separate line of esophageal variceal band ligation(EVL), and searched for the influencing factors of postoperative effect.MethodsThe thesis retrospectively summarized clinical data of GV patients who received two types of treatment in our department:90 patients received EGVL,and another 141 patients received EVL. The thesis compared the difference in the degree of GV varices, postoperative elimination rate, rebleeding rate, recurrence rate and survival time between the two groups, and then, analysised the effect of the gastrorenal or splenorenal shunts on postoperative patients with GV.ResultsThe consequences of the comparison revealed that there was no difference either between the two groups of GOV1 or between GOV1+ GOV2, as well as the degree of GV varices between IGV1(P>0.05). However, there was difference in the degree of GV varices between the two groups of GOV2 (P<0.01). In EGVL group, the hemostasis rate was 97.8%,the eliminating rate was 92.2%, the recurrence rate was 13.3%, the rebleeding rate was 18.2%. By contrast, In EVL group, the hemostasis rate was92.9%,the eliminating rate was 55.2%the recurrence rate was 10.8%,the rebleeding rate was 32.8%.Differences were found in elimination rate of GV and rebleeding rate(χ2=35.155, P<0.01; χ2=5.734, P=0.017). No difference was found in recurrence rate(p>0.05). There are differences in eliminating rate and rebleeding rate either between the two groups of GOV1 or between GOV1+GOV2(P<0.01). Difference was found in elimination rate in the two groups of GOV2(P<0.01), not in rebleeding rate(P>0.05) and survival time(P>0.05). The results of Upper abdomen CTA exhibit that 58.3%(42/72) of the GV with gastrorenal or splenorenal shunts, there were differences in recurrence rate of GV and rebleeding rate between with and without the gastrorenal or splenorenal shunts(χ2= 9.914, P< 0.01;χ2= 7.200, P< 0.01).ConclusionsIn the terms of postoperative GV eliminate and rebleeding, EGVL was better than EVL.Both EGVL and EVL were effective for the treatment of bleeding form GV and prevention of rebleeding. The gastrorenal or splenorenal shunts have an effect on the GV recurrence and rebleeding.