THE EFFECTIVENESS OF ENDOSCOPIC INTERVENTIONS IN LIVER CIRRHOSIS PATIENTS
Abstract
Aim. To analyze the survival of liver cirrhosis patients and to assess the effectiveness of endoscopic interventions to prevent bleedings of portal genesis. Material and М ethods. The study included 449 liver cirrhotic patients with portal hypertension and bleeding from gastroesophageal varices. All patients were divided into 2 groups. The main group included 239 patients for the period 2010–2015 and the control group – 210 patients for the period 1996–2010. Results. There were 33 (27%) patients without recurrent variceal bleeding after endoscopic interventions in the control group and 64 (54.2%) patients in the main group. These values were 32.4% (45) and 109 (61.6%) respectively in case of staged approach including endoscopic hemostasis followed by portosystemic bypass. Long-term recurrence-free period was observed in 40.7% (33) cases of the control group and in 68.1% (64 of 94) cases of the main group after endoscopy. In case of endoscopic interventions followed by portosystemic bypass recurrence was absent in 45.9% (45 of 98 patients) and 71.2% (102 out of 153 patients) in both groups respectively. Conservative therapy alone was effective only in 3 (10.7%) cases to prevent recurrent bleeding that determines its low therapeutic ineffectiveness. Conclusion. Modern possibilities of endoscopic technologies have significantly improved treatment and prevention of variceal bleeding. Staged application of endoscopy and portosystemic decompression improves 1-year survival from 80% to 88% and 3-year survival from 42% to 64%.