Useful Endoscopic Ultrasonography Parameters and a Predictive Model for the Recurrence of Esophageal Varices and Bleeding after Variceal Ligation

• Published in: Gut and liver Vol. 11; no. 6; pp. 843 - 851
• Main Authors: Jeong, Soung Won, Kim, Hye Soo, Kim, Sang Gyune, Yoo, Jeong-Ju, Jang, Jae Young, Lee, Sae Hwan, Kim, Hong Soo, Lee, Ji Sung, Kim, Young Seok, Kim, Boo Sung
• Format: Journal Article
• Language: English
• Published: Korea (South) Editorial Office of Gut and Liver 01.11.2017; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: Adult; endosonography; Endosonography - methods; Endosonography - statistics & numerical data; esophageal and gastric varices; Esophageal and Gastric Varices - diagnostic imaging; Esophageal and Gastric Varices - pathology; Esophageal and Gastric Varices - therapy; Female; Gastrointestinal Hemorrhage - diagnostic imaging; Gastrointestinal Hemorrhage - pathology; Gastrointestinal Hemorrhage - therapy; hemorrhage; Humans; Ligation - methods; Male; Middle Aged; Original; Postoperative Period; Predictive Value of Tests; Recurrence; 내과학; Recurrence; Endosonography; Hemorrhage; Esophageal and gastric varices
• ISSN: 1976-2283; 2005-1212; 2005-1212
• DOI: 10.5009/gnl16458

To identify the usefulness of endoscopic ultrasonography with a mini-probe (EUM) and to create a predictive model for esophageal variceal (EV) recurrence and bleeding following esophageal variceal ligation (EVL). A total of 144 patients who received EUM prior to prophylactic EVL and met the inclusion criteria were enrolled. EUM findings, EV diameter, paraesophageal vein diameter, and the number of perforating veins were assessed. EV recurrence was observed in 42 patients (29.2%), 10 of whom experienced EV bleeding. Larger diameter of the paraesophageal vein (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.17 to 1.96; p=0.002) and perforating vein (OR, 3.27; 95% CI, 1.11 to 9.65; p=0.032) were significant predictive factors for EV recurrence. However, the diameter of the paraesophageal vein was the only significant risk factor for EV bleeding (adjusted OR, 1.51; 95% CI, 1.06 to 2.16; p=0.022). The areas under the curves of the predictive model for EV recurrence and bleeding were 0.872 (95% CI, 0.811 to 0.934) and 0.811 (95% CI, 0.630 to 0.992), respectively. The diameter of the paraesophageal vein was a significant predictive factor for EV recurrence and bleeding. The predictive model constructed based on the significant EUM findings exhibited good performance.