Endoscopic therapy for bleeding esophageal varices improves the outcome of Child C cirrhotic patients

Shinichiro Hori, Akinobu Takaki, Hiroyuki Okada, Akiko Fujiwara, Ryuta Takenaka, Chiho Makidono, Yasushi Shiratori

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and Aim: Bleeding from esophageal varices is one of the frequent severe complications arising in patients with liver cirrhosis. The management of esophageal varices is therefore important for patient survival. The purpose of this study was to clarify the predictive factors for mortality in patients with Child C cirrhosis presenting with variceal bleeding. Methods: A retrospective analysis of 77 Child C cirrhotic patients with bleeding from esophageal varices was conducted. All patients received endoscopic therapy. Twenty-nine patients received endoscopic variceal ligation, and 48 patients received endoscopic injection sclerotherapy or endoscopic injection sclerotherapy with ligation. Univariate and multivariate analyses of clinical data were performed to identify the prognostic factors for survival for these 77 patients. Results: Fifty-seven of 77 patients received endoscopic therapy within 24 h after variceal bleeding, and bleeding was controlled in 55 (96.5%). The remaining 20 patients received endoscopic therapy more than 24 h after bleeding. Higher bilirubin level and rebleeding were the predictive parameters for 6-week survival in the 77 patients, according to univariate and multivariate analysis. Higher bilirubin level, refractory ascites, and the presence of hepatocellular carcinoma were the predictive parameters for mortality in 77 patients as determined by multivariate analysis. Conclusions: Endoscopic therapy was effective in controlling acute variceal bleeding of Child C cirrhotic patients. The prognosis of Child C stage patients presenting with variceal bleeding depended on the severity of liver damage and the presence of hepatocellular carcinoma.

Original languageEnglish
Pages (from-to)1704-1709
Number of pages6
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume21
Issue number11
DOIs
Publication statusPublished - 2006

Fingerprint

Esophageal and Gastric Varices
Hemorrhage
Therapeutics
Sclerotherapy
Multivariate Analysis
Bilirubin
Ligation
Survival
Hepatocellular Carcinoma
Injections
Mortality
Ascites
Liver Cirrhosis

Keywords

  • Child C cirrhosis
  • Endoscopic therapy
  • Esophageal varices

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Endoscopic therapy for bleeding esophageal varices improves the outcome of Child C cirrhotic patients. / Hori, Shinichiro; Takaki, Akinobu; Okada, Hiroyuki; Fujiwara, Akiko; Takenaka, Ryuta; Makidono, Chiho; Shiratori, Yasushi.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 21, No. 11, 2006, p. 1704-1709.

Research output: Contribution to journalArticle

Hori, Shinichiro ; Takaki, Akinobu ; Okada, Hiroyuki ; Fujiwara, Akiko ; Takenaka, Ryuta ; Makidono, Chiho ; Shiratori, Yasushi. / Endoscopic therapy for bleeding esophageal varices improves the outcome of Child C cirrhotic patients. In: Journal of Gastroenterology and Hepatology (Australia). 2006 ; Vol. 21, No. 11. pp. 1704-1709.
@article{de6ab924f8094593a588ec84f3658f67,
title = "Endoscopic therapy for bleeding esophageal varices improves the outcome of Child C cirrhotic patients",
abstract = "Background and Aim: Bleeding from esophageal varices is one of the frequent severe complications arising in patients with liver cirrhosis. The management of esophageal varices is therefore important for patient survival. The purpose of this study was to clarify the predictive factors for mortality in patients with Child C cirrhosis presenting with variceal bleeding. Methods: A retrospective analysis of 77 Child C cirrhotic patients with bleeding from esophageal varices was conducted. All patients received endoscopic therapy. Twenty-nine patients received endoscopic variceal ligation, and 48 patients received endoscopic injection sclerotherapy or endoscopic injection sclerotherapy with ligation. Univariate and multivariate analyses of clinical data were performed to identify the prognostic factors for survival for these 77 patients. Results: Fifty-seven of 77 patients received endoscopic therapy within 24 h after variceal bleeding, and bleeding was controlled in 55 (96.5{\%}). The remaining 20 patients received endoscopic therapy more than 24 h after bleeding. Higher bilirubin level and rebleeding were the predictive parameters for 6-week survival in the 77 patients, according to univariate and multivariate analysis. Higher bilirubin level, refractory ascites, and the presence of hepatocellular carcinoma were the predictive parameters for mortality in 77 patients as determined by multivariate analysis. Conclusions: Endoscopic therapy was effective in controlling acute variceal bleeding of Child C cirrhotic patients. The prognosis of Child C stage patients presenting with variceal bleeding depended on the severity of liver damage and the presence of hepatocellular carcinoma.",
keywords = "Child C cirrhosis, Endoscopic therapy, Esophageal varices",
author = "Shinichiro Hori and Akinobu Takaki and Hiroyuki Okada and Akiko Fujiwara and Ryuta Takenaka and Chiho Makidono and Yasushi Shiratori",
year = "2006",
doi = "10.1111/j.1440-1746.2006.04267.x",
language = "English",
volume = "21",
pages = "1704--1709",
journal = "Journal of Gastroenterology and Hepatology (Australia)",
issn = "0815-9319",
publisher = "Wiley-Blackwell",
number = "11",

}

TY - JOUR

T1 - Endoscopic therapy for bleeding esophageal varices improves the outcome of Child C cirrhotic patients

AU - Hori, Shinichiro

AU - Takaki, Akinobu

AU - Okada, Hiroyuki

AU - Fujiwara, Akiko

AU - Takenaka, Ryuta

AU - Makidono, Chiho

AU - Shiratori, Yasushi

PY - 2006

Y1 - 2006

N2 - Background and Aim: Bleeding from esophageal varices is one of the frequent severe complications arising in patients with liver cirrhosis. The management of esophageal varices is therefore important for patient survival. The purpose of this study was to clarify the predictive factors for mortality in patients with Child C cirrhosis presenting with variceal bleeding. Methods: A retrospective analysis of 77 Child C cirrhotic patients with bleeding from esophageal varices was conducted. All patients received endoscopic therapy. Twenty-nine patients received endoscopic variceal ligation, and 48 patients received endoscopic injection sclerotherapy or endoscopic injection sclerotherapy with ligation. Univariate and multivariate analyses of clinical data were performed to identify the prognostic factors for survival for these 77 patients. Results: Fifty-seven of 77 patients received endoscopic therapy within 24 h after variceal bleeding, and bleeding was controlled in 55 (96.5%). The remaining 20 patients received endoscopic therapy more than 24 h after bleeding. Higher bilirubin level and rebleeding were the predictive parameters for 6-week survival in the 77 patients, according to univariate and multivariate analysis. Higher bilirubin level, refractory ascites, and the presence of hepatocellular carcinoma were the predictive parameters for mortality in 77 patients as determined by multivariate analysis. Conclusions: Endoscopic therapy was effective in controlling acute variceal bleeding of Child C cirrhotic patients. The prognosis of Child C stage patients presenting with variceal bleeding depended on the severity of liver damage and the presence of hepatocellular carcinoma.

AB - Background and Aim: Bleeding from esophageal varices is one of the frequent severe complications arising in patients with liver cirrhosis. The management of esophageal varices is therefore important for patient survival. The purpose of this study was to clarify the predictive factors for mortality in patients with Child C cirrhosis presenting with variceal bleeding. Methods: A retrospective analysis of 77 Child C cirrhotic patients with bleeding from esophageal varices was conducted. All patients received endoscopic therapy. Twenty-nine patients received endoscopic variceal ligation, and 48 patients received endoscopic injection sclerotherapy or endoscopic injection sclerotherapy with ligation. Univariate and multivariate analyses of clinical data were performed to identify the prognostic factors for survival for these 77 patients. Results: Fifty-seven of 77 patients received endoscopic therapy within 24 h after variceal bleeding, and bleeding was controlled in 55 (96.5%). The remaining 20 patients received endoscopic therapy more than 24 h after bleeding. Higher bilirubin level and rebleeding were the predictive parameters for 6-week survival in the 77 patients, according to univariate and multivariate analysis. Higher bilirubin level, refractory ascites, and the presence of hepatocellular carcinoma were the predictive parameters for mortality in 77 patients as determined by multivariate analysis. Conclusions: Endoscopic therapy was effective in controlling acute variceal bleeding of Child C cirrhotic patients. The prognosis of Child C stage patients presenting with variceal bleeding depended on the severity of liver damage and the presence of hepatocellular carcinoma.

KW - Child C cirrhosis

KW - Endoscopic therapy

KW - Esophageal varices

UR - http://www.scopus.com/inward/record.url?scp=33748763811&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748763811&partnerID=8YFLogxK

U2 - 10.1111/j.1440-1746.2006.04267.x

DO - 10.1111/j.1440-1746.2006.04267.x

M3 - Article

C2 - 16984593

AN - SCOPUS:33748763811

VL - 21

SP - 1704

EP - 1709

JO - Journal of Gastroenterology and Hepatology (Australia)

JF - Journal of Gastroenterology and Hepatology (Australia)

SN - 0815-9319

IS - 11

ER -