Comparison Of Therapeutic Effect Between Endoscopic Selective Varices Devascularization And Endoscopic Injection Sclerotherapy In Treatment Of Gastroesophageal Varices

Objective:To compare the therapeutic effect of endoscopic selective varices devascularization(ESVD)and endoscopic injection sclerotherapy(EIS)in treatment of liver cirrhosis with gastroesophageal varices type 1(GOV1)with or without gastroesophageal varices type 2(GOV2)variceal bleeding.Methods:A retrospective study was conducted.54 patients with liver cirrhosis complicated with gastroesophageal varices who underwent endoscopic treatment were enrolled,in which 25 cases were in ESVD group and 29 cases in EIS group.The immediate hemostasis rate of gastroesophageal varices(within 72 hours),the recent hemostasis rate(72 hours to 6 weeks),the long-term hemostasis rate(6 weeks to 6 months),the gastroesophageal varices improvement rate(6 months or more),the progression rate of portal vein thrombosis and the regression rate of portal vein thrombosis afterendoscopic treatment were compared between the two groups respectively.Results:There was no statistically significant difference in the general data between two groups(sex,age,cirrhosis duration,splenectomy history,varices severity,Child-Pugh classification,preoperative portal vein thrombosis,postoperative beta blocker use,number of treatments,varices classification)(all P>0.05).The rate of improvement of gastroesophageal varices(37.9% vs.68.0%)between EIS group and ESVD group was statistically significant(P=0.026).There was no statistically significant difference in the immediate hemostasis rate(96.6% vs.100.0%),the recent hemostasis rate(89.7%vs.100.0%)and the long-term hemostasis rate(72.4% vs.72.0%)between EIS group and ESVD group,(all P > 0.05).There was no statistically significant difference between EIS group and ESVD group in the progression rate of portal vein thrombosis(13.8% vs.12.0%),(P>0.05).The regression rate of portal vein thrombosis(11.1% vs.60.0%)between EIS group and ESVD group was statistically significant,(P=0.040).Conclusion:By comparing EIS and ESVD in the treatment of type GOV1 with or without type GOV2 gastroesophageal variceal bleeding,we find that the latter guarantees a higher gastroesophageal varices improvement rate and a better regression rate of portal vein thrombosis,but no significant difference in hemostasis rate between two groups.