Clinical outcomes of balloon-occluded retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage in Korean patients with liver cirrhosis: a retrospective multicenter study
- Authors
- Jang, Se Young; Kim, Go Heun; Park, Soo Young; Cho, Chang Min; Tak, Won Young; Kim, Jeong Han; Choe, Won Hyeok; Kwon, So Young; Lee, Jae Myeong; Kim, Sang Gyune; Kim, Dae Yong; Kim, Young Seok; Lee, Se-Ok; Min, Yang Won; Lee, Joon Hyeok; Paik, Seung Woon; Yoo, Byung Chul; Lim, Jae Wan; Kim, Hong Joo; Cho, Yong Kyun; Sohn, Joo Hyun; Jeong, Jae Yoon; Lee, Yu Hwa; Kim, Tae Yeob; Kweon, Young Oh
- Issue Date
- Dec-2012
- Publisher
- 대한간학회
- Keywords
- Balloon-occluded retrograde transvenous obliteration; Esophageal varices; Gastric varices; Liver cirrhosis; Variceal hemorrhage
- Citation
- Clinical and Molecular Hepatology, v.18, no.4, pp 368 - 374
- Pages
- 7
- Journal Title
- Clinical and Molecular Hepatology
- Volume
- 18
- Number
- 4
- Start Page
- 368
- End Page
- 374
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/14684
- DOI
- 10.3350/cmh.2012.18.4.368
- ISSN
- 2287-2728
2287-285X
- Abstract
- Background/Aims: This study evaluated the clinical outcomes of balloon-occluded retrograde transvenous obliteration (BRTO) for the treatment of hemorrhage from gastric varices (GV) in Korean patients with liver cirrhosis (LC). Methods: We retrospectively analyzed data from 183 LC patients who underwent BRTO for GV bleeding in 6 universitybased hospitals between January 2001 and December 2010. Results: Of the 183 enrolled patients, 49 patients had Child-Pugh (CP) class A LC, 105 had CP class B, and 30 had CP class C at the time of BRTO. BRTO was successfully performed in 177 patients (96.7%). Procedure-related complications (e. g., pulmonary thromboembolism and renal infarction) occurred in eight patients (4.4%). Among 151 patients who underwent follow-up examinations of GV, 79 patients (52.3%) achieved eradication of GV, and 110 patients (72.8%) exhibited marked shrinkage of the treated GV to grade 0 or I. Meanwhile, new-appearance or aggravation of esophageal varices (EV) occurred in 54 out of 136 patients who underwent follow-up endoscopy (41.2%). During the 36.0 +/- 29.2 months (mean +/- SD) of follow-up, 39 patients rebled (hemorrhage from GV in 7, EV in 18, nonvariceal origin in 4, and unknown in 10 patients). The estimated 3-year rebleeding-free rate was 74.8%, and multivariate analysis showed that CP class C was associated with rebleeding (odds ratio, 2.404; 95% confidence-interval, 1.013-5.704; P= 0.047). Conclusions: BRTO can be performed safely and effectively for the treatment of GV bleeding. However, aggravation of EV or bleeding from EV is not uncommon after BRTO; thus, periodic endoscopy to follow-up of EV with or without prophylactic treatment might be necessary in LC patients undergoing BRTO.
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