The Clinical Application Of Percutaneous Transhepatic Fixed TH Glue Embolization Of Gastric Varices Linking With Partial Splenic Embolization

ObjectiveTo study the clinical results of Percutaneous transhepatic fixed TH glue embolization of Gastric varices linking with partial splenic embolization.Methods30 patients with gastric varices(without or with light esophageal varices) found by gastroscope were treated by Percutaneous transhepatic fixed TH glue embolization linking with partial splenic embolization from 2003 to 2006 in Shandong provincial hospital. We obstruct the gastric-renal shut with ballon before inject fixed TH glue in 14 patients with pachy gastric-renal shut, the other 16 patients were treated by Percutaneous transhepatic fixed TH glue embolization simply.To value the clinic effect ,wo made a long-term follow-up( 11 -33months) to observe the effective power, the replase rate of varices, and the rebleeding rate.ResultsAll of the 30 patients was done successfully, there was no severe complication has been found. The portal venous pressure decreased after the operation. The effective power of varices was 100% , the replase rate was 14.29% (3/21) , the rebleeding rate was 9.52% (2/21) . And reasons of rebleeding were both portal hypertensive gastropathy. Percutaneous transhepatic portography (PTP ) was done to prove there were no blood flow flowing to the shunt left renal vein, and the varicose veins disappeared, when reviewing all of the patients by CT, we found the TH gel extensively feeding in gastric varicose vein and veins supporting for it such as post gastric vein ,short gastric vein ,left gastric vein. During the operation no Symptoms or performance suggesting ectopic embolization has been found. However, A few TH gel was found depositing at lung scatteredly in one case of patients when been reviewed by X-ray.ConclusionsGastric varices and venous supporting them were embolized completely after percutaneous transhepatic fixing TH glue and partial embolizating splenic arteries, and the gastro-renal shunt was remained with high effective power, low replase rate of varices and low rebleeding rate. So percutaneous transhepatic fixed TH glue embolization of Gastric varices linking with partial splenic embolization is reasonable and effective in treatment of hemorrhage from gastric varices.