위 정맥류 출혈에 대한 내시경적 정맥류 폐색술, 내시경적 정맥류 결찰술, 역행성 경정맥 위정맥류 폐색술 간의 치료효과 비교

• Published in: The Korean journal of gastroenterology Vol. 57; no. 5; pp. 302 - 308
• Main Authors: 김부성, Boo Sung Kim, 박재우, Park jae woo, 민슬기, Seul Ki Min, 김상균, Sang Gyune Kim, 김영석, Young Seok Kim, 배준용, Jun Yong Bae, 이종찬, Jong Chan Lee, 김홍수, Hong Soo Kim, 정승원, Soung Won Jeong, 장재영, Jae Young Jang, 문종호, Jong Ho Moon, 이문성, Moon Sung Lee
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 30.05.2011
• Subjects: Esophageal and gastric varices; Gastrointestinal hemorrhage; Liver cirrhosis; Treatment; 내과학
• ISSN: 1598-9992; 2233-6869

Background/Aims: Endoscopic variceal obliteration (EVO), endoscopic variceal ligation (EVL), and balloon-occluded retrograde transvenous obliteration (BRTO) are used to manage gastric variceal bleeding. We compared the re-bleeding rates and survival times of these modalities. Methods: The study enrolled 103 patients with suspected gastric variceal bleeding between July 2001 and May 2009. For the management of gastric variceal bleeding, 52 patients underwent EVO; 36, EVL; and 15, BRTO. We evaluated their laboratory results and vital signs, and calculated the Child score, Child classification, and Model for End-stage Liver Disease score. Rebleeding was defined as new-onset hematemesis, hematochezia, melena, or endoscopically proven bleeding. Time-to-rebleeding and survival time were examined by Kaplan-Meyer analysis. A value of p＜0.05 indicated statistical significance. Results: There were no significant differences in baseline characteristics among the three groups. The overall follow-up period averaged 65.13 months. During follow-up, rebleeding occurred in 17 patients (11 EVO, 5 EVL, and 1 BRTO). The times-to-rebleeding were 63.59, 75.79, and 51.41 months for EVO, EVL, and BRTO, respectively, and did not differ significantly (p=0.515). The median survival times were 77.42, 70.14, and 42.79 months, respectively, and also were not different significantly (p=0.978). Conclusions: There were no significant differences in the time-to-rebleeding or survival time among EVO, EVL, and BRTO. Further prospective, large-scale studies are needed. (Korean J Gastroenterol 2011;57:302-308)