Endoscopic management of esophagogastric varices in patients with liver cirrhosis

doi:10.3877/cma.j.issn.2095-7157.2024.03.010

Abstract

Abstract:

Liver cirrhosis is the most common cause of portal hypertension.Esophagogastric variceal bleeding (EVB) is the most serious complication of portal hypertension and the most important cause of high mortality in liver cirrhosis.Digestive endoscopy plays a pivotal role in preventing and treating EVB.In this review, we summarized the current status of endoscopic management in different stages of EVB in patients with cirrhosis.

Key words: Esophageal varices, Gastric varices, Endoscopic treatment

Shuai Zhang, Xiaobin Zhang, Yingdi Liu, Enqiang Linghu. Endoscopic management of esophagogastric varices in patients with liver cirrhosis[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2024, 11(03): 191-194.

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References 36

[1]	徐小元，丁惠国，李文刚，等．肝硬化诊治指南[J].临床肝胆病杂志，2019，35(11)：2408-2425.
[2]	Gunarathne LS，Rajapaksha H，Shackel N，et al.Cirrhotic portal hypertension：From pathophysiology to novel therapeutics[J].World J Gastroenterol，2020，26(40)：6111-6140.
[3]	Seo YS.Prevention and management of gastroesophageal varices[J].Clin Mol Hepatol，2018，24(1)：20-42.
[4]	中华医学会消化内镜学分会食管胃静脉曲张内镜诊断与治疗学组．肝硬化门静脉高压食管胃静脉曲张内镜下硬化治疗专家共识(2022，长沙) [J/CD].中华胃肠内镜电子杂志，2022，9(4)：181-192.
[5]	Reiberger T，Mandorfer M．Beta adrenergic blockade and decompensated cirrhosis[J].J Hepatol，2017，66(4)：849-889.
[6]	de Franchis R，Bosch J，Garcia-Tsao G，et al.Baveno Ⅶ-Renewing consensus in portal hypertension [J].J Hepatol，2022，76(4)：959-974.
[7]	Kaplan DE，Ripoll C，Thiele M，et al.AASLD Practice Guidance on risk stratification and management of portal hypertension and varices in cirrhosis[J].Hepatology，2024，79(5)：1180-1211.
[8]	de Mattos ÂZ，Terra C，Farias AQ，et al.Primary prophylaxis of variceal bleeding in patients with cirrhosis：A comparison of different strategies[J]. World J Gastrointest Endosc，2021，13(12): 628-637.
[9]	Li QQ，Li HY，Bai ZH，et al.Esophageal collateral veins in predicting esophageal variceal recurrence and rebleeding after endoscopic treatment: a systematic review and meta-analysis[J].Gastroenterol Rep (Oxf)，2020, 8(5)：355-361.
[10]	中华医学会肝病学分会，中华医学会消化病学分会，中华医学会消化内镜学分会．肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J].中华内科杂志，2023，62(1)：7-22.
[11]	Albillos A，Zamora J，Martínez J，et al.Stratifying risk in the prevention of recurrent variceal hemorrhage：Results of an individual patient meta-analysis[J].Hepatology，2017，66(4)：1219-1231.
[12]	Pose E，Napoleone L，Amin A，et al.Safety of two different doses of simvastatin plus rifaximin in decompensated cirrhosis (LIVERHOPE-SAFETY): a randomised, double-blind，placebo-controlled，phase 2 trial[J]. Lancet Gastroenterol Hepatol，2020，5(1): 31-41.
[13]	Ardevol A，Alvarado-Tapias E，Garcia-Guix M，et al.Early rebleeding increases mortality of variecal bleeders on secondary prophylaxis with β-blockers and ligation[J].Dig Liver Dis，2020，52(9)：1017-1025.
[14]	Harras F，Shetael S，Shehata M，et al.Endoscopic band ligation plus argon plasma coagulation versus scleroligation for eradication of esophageal varices[J].J Gastroenterol Hepatol，2010，25(6)：1058-1065.
[15]	Bai Z，Wang R，Cheng G，et al.Outcomes of early versus delayed endoscopy in cirrhotic patients with acute variceal bleeding：a systematic review with meta-analysis[J].Eur J Gastroenterol Hepatol，2021，33(1S Suppl 1): e868-e876.
[16]	Lau JYW，Yu Y，Tang RSY，et al.Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding[J].N Engl J Med，2020，382(14)：1299-1308.
[17]	Jung DH，Huh CW，Kim NJ，et al.Optimal endoscopy timing in patients with acute variceal bleeding：A systematic review and meta-analysis[J].Sci Rep，2020，10(1)：4046.
[18]	Zhang W，Huang Y，Xiang H，et al.Timing of endoscopy for acute variceal bleeding in patients with cirrhosis (CHESS1905)：A nationwide cohort study[J].Hepatol Commun，2023，7(5)：e0152.
[19]	Nett A，Binmoeller KF.Endoscopic Management of Portal Hypertension-related Bleeding[J].Gastrointest Endosc Clin N Am，2019, 29(2)：321-337.
[20]	Kapoor A，Dharel N，Sanyal AJ.Endoscopic Diagnosis and Therapy in Gastroesophageal Variceal Bleeding[J].Gastrointest Endosc Clin N Am, 2015，25(3)：491-507.
[21]	Onofrio FQ，Pereira-Lima JC，Valença FM，et al.Efficacy of endoscopic treatments for acute esophageal variceal bleeding in cirrhotic patients: systematic review and meta-analysis[J].Endosc Int Open，2019，7(11): E1503-1514.
[22]	Nevens F，Bittencourt PL，Coenraad MJ，et al.Recommendations on the Diagnosis and Initial Management of Acute Variceal Bleeding and Hepatorenal Syndrome in Patients with Cirrhosis[J].Dig Dis Sci，2019, 64(6)：1419-1431.
[23]	Elsebaey MA，Tawfik MA，Ezzat S，et al.Endoscopic injection sclerotherapy versus N-Butyl-2 Cyanoacrylate injection in the management of actively bleeding esophageal varices：a randomized controlled trial[J].BMC Gastroenterol，2019，19(1)：1-7.
[24]	Nadler J，Stankovic N，Uber A，et al.Outcomes in variceal hemorrhage following the use of a balloon tamponade device[J].Am J Emerg Med, 2017，35(10)：1500-1502.
[25]	Liu B，Li G．Progress in Endoscopic and Interventional Treatment of Esophagogastric Variceal Bleeding[J].Dis Markers，2022，2022：2940578.
[26]	Mishra SR，Sharma BC，Kumar A，et al.Primary prophylaxis of gastric variceal bleeding comparing cyanoacrylate injection and beta-blockers: a randomized controlled trial[J].J Hepatol，2011，54(6)：1161-1167.
[27]	中华医学会消化内镜学分会食管胃静脉曲张内镜诊断与治疗学组．肝硬化门静脉高压消化道静脉曲张内镜下组织胶注射治疗(2022，长沙)[J/CD].中华胃肠内镜电子杂志，2022，9(4)：193-206.
[28]	Bhat YM，Weilert F，Fredrick RT，et al.EUS-guided treatment of gastric fundal varices with combined injection of coils and cyanoacrylate glue：a large U．S. experience over 6 years (with video)[J].Gastrointest Endosc, 2016，83(6)：1164-1172.
[29]	Khoury T，Nadella D，Wiles A，et al.A review article on gastric varices with focus on the emerging role of endoscopic ultrasound-guided angiotherapy [J].Eur J Gastroenterol Hepatol，2018，30(12)：1411-1415.
[30]	Mishra SR，Chander Sharma B，Kumar A，et al.Endoscopic cyanoacrylate injection versus beta-blocker for secondary prophylaxis of gastric variceal bleed：a randomised controlled trial[J].Gut，2010，59(6)：729-735.
[31]	Chen WC，Hsin IF，Chen PH，et al.Addition of Carvedilol to Gastric Variceal Obturation Does Not Decrease Recurrence of Gastric Variceal Bleeding in Patients With Cirrhosis[J].Clin Gastroenterol Hepatol，2019，17(11)：2356-2363.e2.
[32]	Robles-Medranda C，Oleas R，Valero M，et al.Endoscopic ultrasonography-guided deployment of embolization coils and cyanoacrylate injection in gastric varices versus coiling alone：a randomized trial[J].Endoscopy, 2020，52(4)：268-275.
[33]	Garcia-Pagán JC，Barrufet M，Cardenas A，et al.Management of gastric varices[J].Clin Gastroenterol Hepatol，2014，12(6)：919-928.e1; quiz e51-52.
[34]	Vaz K，Efthymiou M，Vaughan R，et al.Unpacking the challenge of gastric varices：A review on indication，timing and modality of therapy[J].World J Hepatol，2021，13(8)：868-878.
[35]	李长政.《肝硬化门静脉高压食管胃静脉曲张内镜下组织胶注射治疗及硬化治疗专家共识》解读-食管胃静脉曲张内镜治疗失败的挽救措施[J/CD].中华胃肠内镜电子杂志，2023，10(1)：5-6.
[36]	Sarin SK，Mishra SR.Endoscopic therapy for gastric varices[J].Clin Liver Dis，2010，14(2) 263-279.

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