Sunshine News (Reporter Zhang Hua) Recently, the Second Ward of the Department of Gastroenterology of Chang'an District Hospital in Xi'an successfully performed endoscopic esophageal variceal ligation for a patient with liver cirrhosis, relieving the patient's long-term pain and taking another solid step in the field of endoscopic treatment.
A week ago, patient Zhang developed sclera (the main component of the eyeball wall), yellow staining of the skin, yellow urine, accompanied by symptoms such as lack of appetite and fatigue, which seriously affected his life. After taking medicine in the local area, in order to seek further diagnosis and treatment, he sought out Li Yiming, director of the second ward of the Department of Gastroenterology of Chang'an District Hospital in Xi'an.
After admission, the doctor team actively improved the relevant examinations, and the imaging showed that the liver contour was incomplete, and liver cirrhosis was considered; Combined with clinical laboratory examinations, it was found that the patient had serious complications such as secondary changes in the gallbladder, splenomegaly, widening of the portal vein, ascites effusion, and peritonitis. Among them, esophageal varices, as one of the important complications of portal hypertension in liver cirrhosis, pose a serious threat to the life safety of patients.
In order to further clarify whether the patient has esophageal variceal symptoms and severity, the doctor team conducted a gastroscopic examination for the patient, and found that three blue-purple beaded variceal veins could be seen below 30cm from the incisors in the esophagus, with a positive red sign and a maximum diameter of 0.5cm.
During the operation, the team of doctors used an elastic rubber snare ligator to precisely tie the varicose veins in the four walls of the esophagus. The operation went smoothly and the patient did not experience chest pain, hematemesis, hematochezia and other uncomfortable symptoms. After surgery, the patient recovered well and has now returned to a normal diet.
It is understood that esophageal-gastric varices are one of the most serious complications of portal hypertension in liver cirrhosis, and the mortality rate of patients with initial bleeding is as high as 48%~62%. Endoscopic treatment is one of the main treatment measures for esophageal-gastric varices, including endoscopic banding (EVL), endoscopic sclerosing agent injection (EVS), and endoscopic tissue glue injection.
Endoscopic banding (EVL) refers to the surgical method of ligating the root of varicose veins with elastic rubber bands under endoscopic guidance, interrupting the blood flow of varicose veins, forming thrombosis at the banding site, and then tissue ischemia and necrosis, so as to achieve hemostasis, prevent bleeding and quickly eliminate varicose veins.
Indications
Patients with esophageal varices and/or gastric variceal bleeding that do not respond to hemostasis with medication; Previous rebleeding after shunt, deflow or splenectomy; several hours after translumen tube compression and temporary hemostasis by vasopressin or somatostatin; Severe esophageal varices, history of bleeding, poor general condition, unable to tolerate surgery; Elective treatment to prevent bleeding from esophageal varices.