Background
Methods
Patients
Endoscopic therapies
Endoscopic ultrasound probe examinations(EUP)
CT angiography
Clinical and laboratory data
The end-points and follow-up protocol
Statistical analysis
Results
Demographic and clinical characteristics
Variable | ||
---|---|---|
Age(year) | All cases | 55.2 ± 11.9(28–75) |
Gender(n, %) | Male | 100, 65.4 |
Female | 53, 34.6 | |
Etiology of cirrhosis(n, %) | ||
hepatitis B | 100, 65.4 | |
hepatitis C | 11, 7.2 | |
alcoholic liver disease | 19, 12.4 | |
nonalcoholic fatty liver disease | 10, 6.5 | |
autoimmune liver disease | 10, 6.5 | |
unknown causes | 3, 2.0 | |
Cirrhosis with liver cancer(n,%) | Yes | 19, 12.4 |
NO | 134, 87.6 | |
Child-Pugh class (n,%) | A | 96, 62.7 |
B | 43, 28.1 | |
C | 14, 9.2 | |
Endoscopic treatment (n,%) | EVL | 54, 35.3 |
EIS | 80, 52.3 | |
EVL + EIS | 19, 12.4 | |
Recurrence of EV (n,%) | within 1 year | 89, 58.2 |
1–3 years | 54, 35.3 | |
Mean time of recurrence (months) | From eradication to recurrence | 13.4 |
Risk factors associated with recurrence of esophageal varices
Within 1 year recurrence group (n = 89) | 1–3 years recurrence(n = 54) | Without variceal recurrence group(n = 10) | P value | |
---|---|---|---|---|
Gender | ||||
Male(n,%) | 58, 65.2 | 36, 66.7 | 6, 60 | 0.91 |
Female(n,%) | 31, 34.8 | 18, 33.3 | 4, 40 | |
Endoscopic treatment | 0.02 | |||
EVL(n,%) | 39, 43.8 | 14, 25.9 | 1, 10 | |
EIS(n,%) | 39, 43.8 | 32, 59.3 | 9, 90 | |
EVL + EIS(n,%) | 11, 12.4 | 8, 14.8 | 0, 0 | |
Variceal diameter(cm) | 1.22 ± 0.31 | 1.20 ± 0.3 | 0.9 ± 0.2 | 0.03 |
Red signs before treatment(Y/N) | 68/21 | 36/18 | 5/5 | 0.14 |
Gastric varices(Y/N) | 26/63 | 13/41 | 0/10 | 0.13 |
Diameter of peri-ECV(mm) | 3.7 ± 1.4 | 2.5 ± 1.1 | 1.7 ± 0.9 | 0.0 |
Existence or not of PFV (Y/N) | 57/32 | 2/52 | 0/10 | 0.0 |
Diameter of PFV(mm) | 1.9 ± 1.6 | 0.1 ± 0.4 | 0 | 0.0 |
Diameter of para-ECV(mm) | 6.5 ± 2.2 | 5.9 ± 1.9 | 6.9 ± 3.7 | 0.28 |
Primary/secondary preventions(n) | 15/74 | 13/41 | 3/7 | 0.44 |
Child-Pugh grade(n,%) | 0.04 | |||
A | 49, 55.1 | 39, 72.2 | 8, 80 | |
B | 27, 30.3 | 14, 25.9 | 2, 20 | |
C | 13, 14.6 | 1, 1.9 | 0, 0 | |
Child-Pugh score | 7.3 ± 2.1 | 6.5 ± 1.4 | 6.4 ± 0.9 | 0.025 |
MELD score | 7.1 ± 7.8 | 6.9 ± 4.9 | 5.3 ± 2.0 | 0.72 |
CT angiography | ||||
Veins around the esophagus(Y/N) | 81/8 | 50/4 | 9/1 | 0.93 |
Veins around fundus (Y/N) | 63/26 | 38/16 | 6/4 | 0.77 |
Other collateral vein(Y/N) | 12/77 | 11/43 | 2/8 | 0.53 |
Portal vein embolus(Y/N) | 25/64 | 10/44 | 3/7 | 0.41 |
With liver cancer/cirrhosis | 8/81 | 9/45 | 2/8 | 0.31 |
Etiology of cirrhosis(n, %) | 0.28 | |||
hepatitis B | 60, 67.4 | 33, 61.1 | 7, 70 | |
hepatitis C | 2, 2.2 | 8, 14.8 | 1, 10 | |
alcoholic liver disease | 14, 15.7 | 4, 7.4 | 1, 10 | |
nonalcoholic fatty liver disease | 6, 6.8 | 3, 5.6 | 1, 10 | |
autoimmune liver disease | 6, 6.8 | 4, 7.4 | 0, 0 | |
unknown causes | 1, 1.1 | 2, 3.7 | 0, 0 |
Effects of different endoscopic treatments on esophageal varicel recurrence
EVL group (n = 54) | EIS group (n = 80) | EVL + EIS group (n = 19) | P value | |
---|---|---|---|---|
Course number of endoscopic treatment course to variceal eradication | 1.9 ± 0.7 | 3.2 ± 1.2a | 3.4 ± 1.6a | 0.00 |
Median time of variceal recurrence(month) | 10 | 13a | 12 | 0.01 |
EUS findings | ||||
diameter of peri-ECV(mm) | 2.9 ± 1.4 | 3.4 ± 1.5 | 2.9 ± 1.1 | 0.14 |
diameter of PFV(mm) | 1.44 ± 1.5 | 0.9 ± 1.5 | 1.0 ± 1.3 | 0.15 |
existence or not of PFV(Y/N,n) | 29/25 | 24/56a | 6/13 | 0.01 |
diameter of para-ECV(mm) | 6.2 ± 2.1 | 6.3 ± 2.3 | 6.3 ± 2.4 | 0.83 |
Esophageal stenosis(Y/N,n) | 0/54 | 9/71a | 0/19 | 0.01 |
Child-Pugh grade(n,%) | 0.21 | |||
A | 29, 53.7 | 57, 71.3 | 10, 52.6 | |
B | 20, 37.0 | 16, 20 | 7, 36.9 | |
C | 5, 9.3 | 7, 8.7 | 2, 10.5 | |
Child-Pugh score | 7.2 ± 2.1 | 6.7 ± 1.7 | 7.2 ± 1.9 | 0.36 |
Portal vein embolus(Y/N, n) | 10/44 | 24/56 | 4/15 | 0.29 |
With liver cancer (n,%) | 7, 13.0 | 9, 11.3 | 3,15.8 | 0.85 |
Unknown causes for cirrhosis | 0 | 2 | 1 |
Comparison of CT angiography and EUP findings
CT angiography | |||
---|---|---|---|
para-ECVs (negative) | para-ECVs (positive) | ||
EUP findings | para-ECV(negative)n,% | 4, 2.6 | 0, 0 |
para-ECV(positive)n,% | 9, 5.9 | 140, 91.5 |