Therapeutic Evaluation of Endoscopic Injection Sclerotherapy for Esophageal Varices by Radioisotopic Splenoportography

Yasuhiro Yokoyama, Natsuki Samejima, Koichiro Ikeda, Kohichi Fujii, Satoshi Hirata, Mamoru Ueda, Eiji Yatsuyanagi, Tetsuya Nozaka, Yoshihiko Kubo

First Department of Surgery, Asahikawa Medical College

Radioisotopic splenoportography was performed in 28 patients with moderate or huge size esophageal varices (Japanese research society for portal hyperension F₂, F₃ varices) before and after endoscopic injection sclerotherapy (EIS). Recurrence was judged endoscopically six months after EIS. In the successful EIS group (17 cases), radioisotopic images (Rl-images) of ascending collaterals such as esophageal varices and the left gastric vein disappeared after EIS, but the images of the short gastric vein did not. In the successful EIS group, Rl-images of descending collaterals such as the paraumbilical veins, splenorenal shunts and the images of the liver were enhanced after EIS. In the varices-relapsed group (11 cases), RI-images after EIS were almost the same as before EIS. Therefore the disappearance of the images of ascending collaterals excluding that of the short gastric vein, and the enhancement of images of descending collaterals and the liver by radioisotopic splenoportography are thought to be good indices for successful EIS. We think radioisotopic splenoportography is a safe and useful modality for therapeutic evaluation of EIS.

Key words
radioisotopic splenoportography, esophageal varices, endoscopic injection sclerotherapy, portosystemic collaterals

Reprint requests
Yasuhiro Yokoyama First Department of Surgery, Asahikawa Medical College
4-5-3-11 Nishikagura, Asahikawa, 078 JAPAN

Accepted
July 10, 1990

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