Effects of Endoscopic Variceal Sclerotherapy on Portal Venous Blood Flow in Patients with Cirrhosis : Evaluation with Doppler Ultrasonography

Park, Sil Moo; Park, Joong won; Yoo, Kyung Kum; Kim, Jae Gyu; Kim, Young Goo; Yoo, Byung Cheol

Abstract

BACKGROUND AND AIMS: It has been well established that endoscopic variceal sclerotherapy (EVS) is an effective therapy for variceal bleeding from esophagus and can improve survival rate in cirrhotic patients. However, the effects or complications of EVS on portal vein (PV), have not been clearly explored. Thus we study the effects of EVS on portal venous blood flow in cirrhotic patients.
METHODS
In 31 patients with liver cirrhosis, portal venous blood flow were measured using Doppler system The parameters evaluated were portal vein cross sectional area, mean portal flow velocity and portal blood flow volume. Fifteen patients were treated three to eight sessions (mean 5.6+/-1.45) with EVS. The remaining patients who had no episode of variceal bleeding but had esophageal varices higher than Fl grade were control. In EVS, we used 5% ethanolamine oleate 10-30 ml/session with intravariceal injection.
RESULTS
The two groups did not show significant statistical difference in age, sex, and Child-Pugh class. In eight cases of EVS-treated group and in four cases of control group, we failed to measure portal venous blood flow. However, the difference was not statistically significant (p> 0.05). The causes of fail in measurements were portal venous tbrombosis (3 cases), gallstones (2 cases), technical difficulty (5 cases) and shrunken liver (2 cases). The measured cross sectional area, mean portal blood flow velocity, and portal blood flow volume were 130.1+/-48.2 mm2, 14.65+/-4.48 cm/sec and 1,960+/-1,134 ml/min respectivey in controls and 102.1+/-50.8 mm2, 9.38+/-4.18 cm/sec and 1,153+/-780 ml/min in EVS-treated group. The values did not showed statistical difference in two groups (p>0.05).
CONCLUSIONS
Chronic endoscopic variceal sclerotherapy did not affect portal venous blood flow in patients with liver cirrhosis.