Hemodynamic changes of left gastric vein before and after endoscropic scleroligation for esophageal varices
We investigated hemodynamic changes following endoscopic sclero-ligation therapy (ESL : EIS combined with EVL therapy) which was performed in six patients with esophageal varices due to liver cirrhosis. Angioraphy before ESL demonstrated that both of the left gastric artery (LGA) and the left gastri...
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Published in | Japanese Journal of Portal Hypertension and Esophageal Varices Vol. 3; no. 3; pp. 201 - 207 |
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Main Authors | , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | Japanese |
Published |
The Japan Society for Portal Hypertension
10.12.1997
日本門脈圧亢進症学会 |
Subjects | |
Online Access | Get full text |
ISSN | 1341-6375 2187-1213 |
DOI | 10.11423/jsph1995.3.3_201 |
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Abstract | We investigated hemodynamic changes following endoscopic sclero-ligation therapy (ESL : EIS combined with EVL therapy) which was performed in six patients with esophageal varices due to liver cirrhosis. Angioraphy before ESL demonstrated that both of the left gastric artery (LGA) and the left gastric vein (LGV) were the feeding vessels for esophageal varices in five patients. Varices in the other patient was fed solely by LGA. Before ESL, flow direction of LGV was hepatoufugal in four, and “to and fro” in two. After ESL, esophageal varices were eradicated in five patients, endoscopically. Of these, flow direction of LGV changed from hepatofugal to hepatopetal in two, from hepatofugal to “to and fro” in two. And in one patient with “to and fro”, the flow of LGV was not demonstrated. The diameter of LGV decreased in three out of four patients with patent LGV after ESL. Esophageal varices were not eradicated in one patient whose varices were fed by LGA alone. ESL neither changed the flow direction nor the diameter of the LGV. It is suggested that ESL embolized LGV completely or imcompletely, and caused subsequent hemodynamic changes for patients for whom LGV was the feeder vessel to the varices. |
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AbstractList | We investigated hemodynamic changes following endoscopic sclero-ligation therapy (ESL : EIS combined with EVL therapy) which was performed in six patients with esophageal varices due to liver cirrhosis. Angioraphy before ESL demonstrated that both of the left gastric artery (LGA) and the left gastric vein (LGV) were the feeding vessels for esophageal varices in five patients. Varices in the other patient was fed solely by LGA. Before ESL, flow direction of LGV was hepatoufugal in four, and “to and fro” in two. After ESL, esophageal varices were eradicated in five patients, endoscopically. Of these, flow direction of LGV changed from hepatofugal to hepatopetal in two, from hepatofugal to “to and fro” in two. And in one patient with “to and fro”, the flow of LGV was not demonstrated. The diameter of LGV decreased in three out of four patients with patent LGV after ESL. Esophageal varices were not eradicated in one patient whose varices were fed by LGA alone. ESL neither changed the flow direction nor the diameter of the LGV. It is suggested that ESL embolized LGV completely or imcompletely, and caused subsequent hemodynamic changes for patients for whom LGV was the feeder vessel to the varices.
食道静脈瘤患者6例に対して内視鏡的硬化・結紮術 (ESL) を行い, その施行前後の血行動態を血管造影にて検討した.治療前は, 静脈瘤への供血路として左胃動脈は全例, 左胃静脈は5例で関与していた.左胃静脈の血流方向は遠肝性4例, to-and-fro性2例であった.治療後, 静脈瘤が完全消失した5例では左胃静脈の血流方向が変化し, 2例が遠肝性から求肝性, 2例が遠肝性からto-and-fro性, 1例がto-and-fro性から左胃静脈描出不能へとそれぞれ変化した.また, 左胃静脈が描出された4例中3例に左胃静脈径の狭小化を認めた.一方, 遺残した症例は静脈瘤供血路が左胃動脈のみであり治療前後でto-and-fro性のまま変化を認めず, 血管径の変化もみられなかった.ESLは, 左胃静脈が静脈瘤に供血する症例に対しては左胃静脈の完全あるいは高度な血栓化により血行動態の変化が生じたと考えられた. We investigated hemodynamic changes following endoscopic sclero-ligation therapy (ESL : EIS combined with EVL therapy) which was performed in six patients with esophageal varices due to liver cirrhosis. Angioraphy before ESL demonstrated that both of the left gastric artery (LGA) and the left gastric vein (LGV) were the feeding vessels for esophageal varices in five patients. Varices in the other patient was fed solely by LGA. Before ESL, flow direction of LGV was hepatoufugal in four, and “to and fro” in two. After ESL, esophageal varices were eradicated in five patients, endoscopically. Of these, flow direction of LGV changed from hepatofugal to hepatopetal in two, from hepatofugal to “to and fro” in two. And in one patient with “to and fro”, the flow of LGV was not demonstrated. The diameter of LGV decreased in three out of four patients with patent LGV after ESL. Esophageal varices were not eradicated in one patient whose varices were fed by LGA alone. ESL neither changed the flow direction nor the diameter of the LGV. It is suggested that ESL embolized LGV completely or imcompletely, and caused subsequent hemodynamic changes for patients for whom LGV was the feeder vessel to the varices. |
Author | Onda, Masahiko Toba, Masahito Hirose, Youichirou Kumazaki, Tatuo Yoshida, Hiroshi Tajiri, Takashi Bandou, Kouichi Umehara, Matuomi Mamada, Yoshihiro Kaneko, Masahiro Yamamoto, Kazuhito Yamashita, Kiyohiko Kojima, Takayuki Matuzaki, Sakae Taniai, Nobuhiko Nishikubo, Hideki Matumoto, Satoshi |
Author_FL | 梅原 松臣 松本 智司 吉田 寛 谷合 信彦 金子 昌裕 真々田 裕宏 廣瀬 洋一郎 隈崎 達夫 小嶋 隆行 鳥羽 昌仁 田尻 孝 恩田 昌彦 山下 精彦 山本 一仁 松崎 栄 坂東 功一 西久保 秀紀 |
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PublicationTitle | Japanese Journal of Portal Hypertension and Esophageal Varices |
PublicationTitleAlternate | Japanese Journal of Portal Hypertension and Esophageal Varices |
PublicationTitle_FL | 日本門脈圧亢進症食道静脈瘤学会雑誌 Japanese Journal of Portal Hypertension and Esophageal Varices |
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Publisher | The Japan Society for Portal Hypertension 日本門脈圧亢進症学会 |
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References | 2) 北野正剛, 磯 泰典, 川中博文, 他 : 食道静脈瘤に対する内視鏡的静脈瘤結紮療法 (EVL) と硬化療法との併用療法.消内視鏡1992;4 : 129-133 4) Masumori K, Onda M, Tajiri T, et al. : Modified endoscopic variceal ligation. Dig Endosc, 1995; 7 : 165-170 1) Stiegmann GV, Cambre T, Sun JH : A New endoscopic elastic band ligating device Gastrointest Endosc 1986; 32 : 230-233 3) 中村真一, 光永 篤, 鈴木 茂, 他 : 食道静脈瘤に対する結紮術 (EVL) と1%Aethoxysklerol静脈瘤外注入併用療法の臨床的検討.Gastoroenterol Endosc 1996;38 : 813-827 9) Nishikawa Y, Hosokawa Y, Doi T, et al. : Simultaneous combination of endoscopic sclerotherapy and ligation for esophageal varices. Gastrointest Endosc, 1995; 42 : 358-360 11) Takase Y, Shibuya S, Chikamori F, et al. : Recurrence factors studied by percutaneous transhepatic portography before and after endoscopic sclerotherapy for esophageal varices. Hepatology, 1990; 11 : 348-352 7) Stiegmann GV, Goff JS : Endoscopic esophageal varix ligation : preliminary clinical experience. Gastorointest Endosc, 1988; 34 : 113-117 6) 日本門脈圧亢進症食道静脈瘤学会編 : 門脈圧充進症取扱い規約, 第1版.金原出版, 東京, 1996 10) 鳥羽昌仁, 恩田昌彦, 田尻孝, 他 : 食道静脈瘤硬化療法における血管塞栓療法併用の有用性-効果不良例及び再発例の検討を中心に-.Gastoroenterol Endosc, 1993; 35 : 2873-2882 5) 梅原松臣, 恩田昌彦, 田尻 孝, 他 : 密集結紮法の成績からみた内視鏡的静脈瘤結紮術 (EVL) 単独治療の限界について.日消病会誌1995;92 : 1233-1237 8) 水本英明, 松谷正一, 福澤 健, 他二門脈血行動態からみた内視鏡的静脈瘤結紮術.臨外1994;49 : 451-456 |
References_xml | – reference: 11) Takase Y, Shibuya S, Chikamori F, et al. : Recurrence factors studied by percutaneous transhepatic portography before and after endoscopic sclerotherapy for esophageal varices. Hepatology, 1990; 11 : 348-352 – reference: 5) 梅原松臣, 恩田昌彦, 田尻 孝, 他 : 密集結紮法の成績からみた内視鏡的静脈瘤結紮術 (EVL) 単独治療の限界について.日消病会誌1995;92 : 1233-1237 – reference: 3) 中村真一, 光永 篤, 鈴木 茂, 他 : 食道静脈瘤に対する結紮術 (EVL) と1%Aethoxysklerol静脈瘤外注入併用療法の臨床的検討.Gastoroenterol Endosc 1996;38 : 813-827 – reference: 4) Masumori K, Onda M, Tajiri T, et al. : Modified endoscopic variceal ligation. Dig Endosc, 1995; 7 : 165-170 – reference: 1) Stiegmann GV, Cambre T, Sun JH : A New endoscopic elastic band ligating device Gastrointest Endosc 1986; 32 : 230-233 – reference: 10) 鳥羽昌仁, 恩田昌彦, 田尻孝, 他 : 食道静脈瘤硬化療法における血管塞栓療法併用の有用性-効果不良例及び再発例の検討を中心に-.Gastoroenterol Endosc, 1993; 35 : 2873-2882 – reference: 2) 北野正剛, 磯 泰典, 川中博文, 他 : 食道静脈瘤に対する内視鏡的静脈瘤結紮療法 (EVL) と硬化療法との併用療法.消内視鏡1992;4 : 129-133 – reference: 7) Stiegmann GV, Goff JS : Endoscopic esophageal varix ligation : preliminary clinical experience. Gastorointest Endosc, 1988; 34 : 113-117 – reference: 8) 水本英明, 松谷正一, 福澤 健, 他二門脈血行動態からみた内視鏡的静脈瘤結紮術.臨外1994;49 : 451-456 – reference: 6) 日本門脈圧亢進症食道静脈瘤学会編 : 門脈圧充進症取扱い規約, 第1版.金原出版, 東京, 1996 – reference: 9) Nishikawa Y, Hosokawa Y, Doi T, et al. : Simultaneous combination of endoscopic sclerotherapy and ligation for esophageal varices. Gastrointest Endosc, 1995; 42 : 358-360 |
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SubjectTerms | angiography endoscopic scleroligation (ESL) esophageal varices hemo-dynamic change |
Title | Hemodynamic changes of left gastric vein before and after endoscropic scleroligation for esophageal varices |
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