Studies on Treatment for Gastric Varices Hased on the Endoscopic Aspects and the Location

Shuichiro Suzuki, Seiichi Kiriyama, Akira Yamada, Kunihiko Shimazaki, Huminori Yamagishi, Mitsuyoshi Shimoda, Isao Shirosaki, Touichi Kushibuchi, Takashi Sakamoto, Yoshiro Yamashita, Yoshiaki Karaki, Kenji Tazawa, Masao Hujimaki

Second Department of Surgery, Toyama Medical and Pharmaceutical University

65 cases with gastric varices that were treated in my department are classified in three types by endoscopic features and the location (Lg-c: varices locate in the cardia or around the cardia. Lg-cf: varices locate in the cardia to the fornix. Lg-f: varices lonely locate in the fornix.). The purpuse of this article was to analyze the selection of treatment and the results. (1) Of 65 cases of gastric varices, 53 cases had Lg-c, 7 cases had Lg-cf and 5 cases had Lg-f. (2) In all patients with Lg-c, remrkable esophageal varices were endoscopically obserbed. In the patients with Lg-cf or Lg-f, the grade and the incidence of combined esophageal varices were lower and lower. (3) The grade of gastric varices was higher, incedence of gastrorenal shunt was higher. All the patients with Lg-f had gastrorenal shunt. (4) Any treatment of operation or sclerotherapy was effective (more than 85%) for gastric varices in the patients with Lg-c. In the patients with Lg-cf effective treatment for esophageal and gastric varices is necessary. In the 3 cases treated by combined therapy (Hassab's ope. + sclerotherapy), Gastric varices disappeared. The patients with Lg-f need direct treatment for gastric varices and in those cases, there are many difficult cases to treat, so the selection of effective treatment is difficult problem.

Key words
gastric varices, gastrorenal shunt, endoscopic sclerotherapy, Hassabs operation

Reprint requests
Shuichiro Suzuki Second Department of Surgery, Toyama Medical and Pharmaceutical University
2630 Sugitani, Toyama, 930-01 JAPAN

Accepted
September 12, 1990

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