TREATMENT STRATEGIES FOR ESOPHAGEAL VARICES

DOI 2 Citations
  • OBARA Katsutoshi
    Department of Advanced Gastrointestinal Endoscopy, Fukushima Medical University.

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  • 食道静脈瘤の治療戦略

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Treatment options for esophageal varices (EV) include conservative medical management (pharmacological therapy, balloon tamponade), endoscopic treatment [endoscopic injection sclerotherapy (EIS), endoscopic variceal ligation (EVL)] and surgical therapy. In Japan, the first-line therapy for bleeding EV is EVL, while both EIS and EVL are popular for elective and prophylactic treatment of EV.<BR>In order to treat EV in a safe and effective manner, it is essential to master comprehensive knowledge such as general rules for recording endoscopic findings of EV and gastric varices, indications and contraindications of EV treatment, mechanism of action of each sclerosant, how to select optimal treatment strategies according to each patient's clinical condition, and portal hemodynamics (obtained by EUS and 3D-CT), and also to learn various treatment techniques, how to find possible complications and preventive measures against them, and how to monitor patients periodically after treatment.<BR>This review article discusses the optimal treatment strategies for EV in Japanese patients as well as those adopted in Western countries based on evidence-based medicine.

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