Editorial
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Mar 21, 2007; 13(11): 1641-1645
Published online Mar 21, 2007. doi: 10.3748/wjg.v13.i11.1641
New methods for the management of esophageal varices
Hiroshi Yoshida, Yasuhiro Mamada, Nobuhiko Taniai, Takashi Tajiri
Hiroshi Yoshida, Yasuhiro Mamada, Nobuhiko Taniai, Takashi Tajiri, Department of Surgery, Nippon Medical School, Tokyo 1138603, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Hiroshi Yoshida, MD, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 1138603, Japan. hiroshiy@nms.ac.jp
Telephone: +81-3-58146239 Fax: +81-3-56850989
Received: March 12, 2007
Revised: March 18, 2006
Accepted: March 23, 2007
Published online: March 21, 2007
Abstract

Bleeding from esophageal varices (EVs) is a catastrophic complication of chronic liver disease. Many years ago, surgical procedures such as esophageal transection or distal splenorenal shunting were the only treatments for EVs. In the 1970s, interventional radiology procedures such as transportal obliteration, left gastric artery embolization, and partial splenic artery embolization were introduced, improving the survival of patients with bleeding EVs. In the 1980s, endoscopic treatment, endoscopic injection sclerotherapy (EIS), and endoscopic variceal ligation (EVL), further contributed to improved survival. We combined IVR with endoscopic treatment or EIS with EVL. Most patients with EVs treated endoscopically required follow-up treatment for recurrent varices. Proper management of recurrent EVs can significantly improve patients’ quality of life. Recently, we have performed EVL at 2-mo (bi-monthly) intervals for the management of EVs. Longer intervals between treatment sessions resulted in a higher rate of total eradication and lower rates of recurrence and additional treatment.

Keywords: Esophageal varices; Surgery; Interventional radiology; Embolization; Endoscopic treatment; Bi-monthly