Percutaneous Transhepatic Portography and the Treatment of Esophagogastric Varices

Makoto Hashizume, Seigo Kitano, Hiroya Wada, Kazuo Tanoue, Keizo Sugimachi

Department of Surgery II, Faculty of Medicine Kyushu University

In 64 patients with portal hypertension, the vascular pattern of the lower esophageal varices was classified into two types, palisading and bar types; the gastric varices were classified into cardiac and fundic types, based on the percutaneous transhepatic portography. The patients with the bar type of esophageal varices had poorer liver function and more of them had a history of bleeding from the esophageal varices than the patients with the palisading type (p<0.05). Significantly more small venous dilation appeared in patients with the bar type after sclerotherapy. It was more difficult to sclerose the esophageal varices of the giant bar type and the tumorous type of gastric varices by sclerotherapy alone than by surgery or the combination therapy of percutaneous transhepatic obliteration of the varices with sclerotherapy. Thus, treatment should probably be designed in each patient according to the vascular pattern of the lower esophagus.

Key words
percutaneous transhepatic portography, selective left gastric venography, treatment of esophagogastric varices

Reprint requests
Makoto Hashizume Department of Surgery II, Faculty of Medicine, Kyushu University
3-1-1 Maidashi, Higashi-ku, Fukuoka, 812 JAPAN

Accepted
November 8, 1989

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