EVLに適した食道静脈瘤の食道周囲血管系EUS所見

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  • EVL or EIS? Appropriate Indication by Endoscopic Ultrasonography using 20 MHz Miniature Probe
  • -20MHz細径プローブによる検討-

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In Japan, endoscopic injection sclerotheraphy (EIS) is used as a complete techneque to eliminate esophageal varices, as is indicated by a low recurrence rate after treatment. While, very frequent and rapid recurrence is common following even if EIS is added after EVL treatment. We have reported that EVL is an easy and effective techneque with a low recurrence rate when applied to cases in whom the degree of RC-sign is semiquantatively lower than +. While a prognosis is very poor when EVL for cases with more severer varice. In this report, we have examined appropriate indications of EVL based on the pictures of endoscopic ultrasonography (EUS) using 20 MHz, miniature probe. Forty cases with esophageal varices were examined and devided to two groups by EUS findings according to our grading system. Twenty eight cases whose vessels surrounding esophagus were graded as more than moderate (Group A) were treated by EIS alone. While, 12 cases with slightly developed vessels (Group B) were treated by EVL followed by the injection of 5% ethanolamine oleate into residual mucosa of the lower esophagus. Cummurative non-recurrence rate after the therapy were compared by the Kaplan Meier's method between two groups. There were no differences in cummurative non-recurrence rates (3 years) between these two groups (Group A : 94.9%, Group B : 100%). These result suggest that EVL is effective when applied to varices whose esophageal vessels around the esophagus were slightly developed.

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