Efficacy of endoscopic sclerotherapy with lauromacrogol in treatment of severe esophageal variceal bleeding

• Main Author: CUI Meilan
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2017-12-01
• Series: Linchuang Gandanbing Zazhi
• Subjects: esophageal and gastric varices; lauromacrogol injection; sclerotherapy; treatment outcome
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=8712

ObjectiveTo investigate the short- and long-term efficacy of endoscopic sclerotherapy with lauromacrogol in the treatment of cirrhotic patients with severe esophageal variceal bleeding. MethodsA retrospective analysis was performed for the clinical data of 160 patients who underwent endoscopic sclerotherapy with lauromacrogol for the first time due to severe esophageal variceal bleeding caused by cirrhotic portal hypertension in The Fifth Hospital of Shijiazhuang from January 2011 to December 2014. These patients were divided into emergency treatment group with 66 patients and selective treatment group with 94 patients. All patients were followed up for 1-5 years, and a statistical analysis was performed for the success rate of hemostasis, short-term rebleeding rate, long-term rebleeding rate, and incidence of complications. The chi-square test or the Fisher′s exact test was used for comparison of categorical data between two groups, and the t-test was used for comparison of continuous data between two groups. ResultsThere were no significant differences between the emergency treatment group and the selective treatment group in the success rate of hemostasis (98.48% vs 100.00%, P＞0.05), rate of eradication or disappearance of varices (74.24% vs 82.98%, P＞0.05), time to the eradication or disappearance of varices (21.4±0.3 d vs 20.5±0.3 d, P＞0.05), variceal recurrence rate (18.18% vs 15.96%, P＞0.05), time to variceal recurrence (17.0±1.8 months vs 19.2±2.3 months, P＞0.05), long-term rebleeding rate (33.33% vs 21.28%, P＞0.05), and incidence rate of complications (22.73% vs 18.09%, P＞0.05), while there was a significant difference in short-term rebleeding rate between the two groups (9.09% vs 1.06%, P=0.020). Of all 160 patients, 8 (5.00%) died during follow-up, including 5 patients in the emergency treatment group (one each died of esophageal variceal bleeding, multiple organ failure, and rupture and bleeding of liver cancer nodules, and 2 died of hepatic encephalopathy) and 3 in the selective treatment group (one patient each died of esophageal variceal bleeding, multiple organ failure, and rupture and bleeding of liver cancer nodules). ConclusionEndoscopic sclerotherapy with lauromacrogol has marked short- and long-term efficacy in the treatment of severe esophageal variceal bleeding, and short-term rebleeding after emergency treatment should be taken seriously.