Original Article

Endoscopic injection sclerotherapy for 1,000 patients with esophageal varices: A nine-year prospective study

  1. Makoto Hashizume*,
  2. Seigo Kitano,
  3. Nobuhiro Koyanagi†,
  4. Kazuo Tanoue,
  5. Masayuki Ohta,
  6. Hiroya Wada,
  7. Hirohiko Yamaga,
  8. Hidefumi Higashi,
  9. Yasunori Iso,
  10. Tetsuya Iwanaga†,
  11. Keizo Sugimachi

Article first published online: 6 DEC 2005

DOI: 10.1002/hep.1840150114

Issue

Hepatology

Hepatology

Volume 15, Issue 1, pages 69–75, January 1992

Additional Information

How to Cite

Hashizume, M., Kitano, S., Koyanagi, N., Tanoue, K., Ohta, M., Wada, H., Yamaga, H., Higashi, H., Iso, Y., Iwanaga, T. and Sugimachi, K. (1992), Endoscopic injection sclerotherapy for 1,000 patients with esophageal varices: A nine-year prospective study. Hepatology, 15: 69–75. doi: 10.1002/hep.1840150114

Author Information

  1. Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka 812, Japan

  1. †

    Department of Surgery, Fukuoka City Hospital, Fukuoka 812, Japan

*Department of Surgery II, Faculty of Medicine, Kyushu University, 3–1-1 Maidashi, Higashi-ku, Fukuoka 812, Japan

Publication History

  1. Issue published online: 6 DEC 2005
  2. Article first published online: 6 DEC 2005
  3. Manuscript Accepted: 11 SEP 1991
  4. Manuscript Received: 31 MAY 1991

Funded by

  • Grant-in Aid for General Scientific Research. Grant Number: 02807122
  • Ministry of Education, Science and Culture of Japan

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Abstract

We report here the results of endoscopic injection sclerotherapy performed in 1,000 consecutively treated Japanese patients with esophageal varices. This prospective study covered the period from 1982 to 1990. Variceal bleeding was controlled in 215 (97.7%) of 220 patients. Esophageal varices were completely eradicated in 778 patients (77.8%); the mean number of sessions was 4.2. In only 3 of the 778 patients did esophageal varices of the same size recur. Small, dilated, venous vessels that required additional sclerotherapy in follow-up endoscopy at 3-mo intervals appeared in 171 (22.2%) of 778 patients. The cumulative nonbleeding rate at 5 yr was 94.5% in patients in whom the varices had been eradicated. Deaths caused by upper gastrointestinal bleeding accounted for 2.6% of cases, whereas the rates of liver failure and hepatoma were 4.6% and 47.3%, respectively. The 5-yr cumulative survival rate was 54.1% in patients without concomitant hepatoma; it was 12.0% in patients with hepatomas. Multivariate analysis showed that hepatoma, Child classification, indication (acute, elective or prophylactic) and eradication were independent factors that significantly influenced survival time. This study clearly shows that close follow-up with endoscopy and complete eradication lead to significant reduction in bleeding from esophageal varices and reduction of mortality related to this bleeding. (HEPATOLOGY 1992;15:69–75).

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