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The Treatment of Esophageal Varices

Research Project

Project/Area Number 61480277
Research Category

Grant-in-Aid for General Scientific Research (B)

Allocation TypeSingle-year Grants
Research Field Digestive surgery
Research InstitutionUniversity of Tokyo

Principal Investigator

IDEZUKI Yasuo  Faculty of Medicine, University of Tokyo, 医学部(病), 教授 (60081717)

Co-Investigator(Kenkyū-buntansha) SAKAMOTO Hirohiko  Faculty of Medicine, University of Tokyo, 医学部外科学一般, 医員 (40196100)
HARIHARA Yasushi  Faculty of Medicine, University of Tokyo, 医学部外科学一般, 助手 (10189714)
OHASHI Kazumasa  Faculty of Medicine, University of Tokyo, 医学部外科学一般, 助手 (50185352)
KAWASAKI Seiji  Faculty of Medicine, University of Tokyo, 医学部外科学一般, 助手 (80177667)
SANJO Kensho  Faculty of Medicine, University of Tokyo, 医学部外科学一般, 講師 (90114503)
Project Period (FY) 1986 – 1987
Project Status Completed (Fiscal Year 1987)
Budget Amount *help
¥7,000,000 (Direct Cost: ¥7,000,000)
Fiscal Year 1987: ¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 1986: ¥4,000,000 (Direct Cost: ¥4,000,000)
Keywordsnon-shunting operation / esophageal varices / esophagogastic devascularization / 血管内注入法 / 血管外注入法 / エチノールアシンオレート / ピトレッシン / バルーンチンボナーデH法 / 門脈圧亢進症 / 食道静脈瘤 / 門脈循環動態 / 肝予備能
Research Abstract

Since 1954, non-shunting operations (454 esophageal transection with esophagogastric devascularization, 43 Hassab's operation, 12 others) has been performed in 509 patients with varices (liver cirrhosis 362, idiopathic portal hypertension 102, extrahepatic portal vein obstruction 38, Schistosomiasis 4, others 3). Esophageal transection was performed transthoracically in 125, transabdominally in 42, and thoracoabdominally in 287.
Overall operative mortality of these non-shunting operations was 5.1% (26/509). Operative deaths occurred only in patients with liver cirrhosis (7.1%, 26/362), and higher in emergency cases (23.3%, 14/60) compared to the elective or prophylactic operations (3.8%, 7/138 for elective operations and 4.2%, 5/119 for prophylactic operations). Operative deaths were observed in 4 of the Child B patients and 22 of the Child C patients. Cummulative survival rate at ten yeard after esophageal transection was been satisfactory in patients with idiopathic portal hypertensio … More n and extrahepatic opetalvein obstruction (75.8%,and 90.1% respectively), but 26.9% in cases of liver cirrhosis.
Dissappearance of esophageal varices was most complete with thoracoabdominal approach where the most extensive devascularization of both the esophagus and the stomach was possibble, however this is a large operation and only recommendable in good risk patients (Child A category). The varices dissappeared completely in 80% of the patients in whom transabdominal transection with EEA was performed, and this operation has been well tolarated in most of the Child A and B patients, and hence most widely recommendable. When the dissapearance of the varices is not complete after this operation, the remaining varices may easily be t reated by endoscopic sclerotherapy. In half of the patients treated by transthoracic transection, some of the esophageal varices above the line of transection remained, and bleeding recurred. The use of transthoracic esophageal transection should be limited as an emergency to stop bleeding in good risk patients (Child A and B). Less

Report

(2 results)
  • 1987 Final Research Report Summary
  • 1986 Annual Research Report
  • Research Products

    (21 results)

All Other

All Publications (21 results)

  • [Publications] 出月康夫: Gastroenterological Endoscopy. 29. 2815-2816 (1987)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] 出月康夫: 外科診察. 28. 1308-1314 (1986)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] 出月康夫: 臨床外科. 41. 1373-1378 (1986)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] 出月康夫: 厚生省特定疾患門脈血行異常症調査研究班報告書. 178-180 (1986)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] 三條健昌: Medicina. 23. 1428-1433 (1986)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] 三條健昌: 消化器科. 5. 482-488 (1986)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] 出月康夫: "図解食道静脈瘤硬化療法" 医学書院, 140 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] 出月康夫: "新外科大系, 肝臓・胆道の外科IV" 中山書店, 350 (1987)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] Yasuo IDEZUKI: "The treatment of esophageal varices" Gastroenterological Endoscopy. 29. 2815-2816 (1987)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] Yasuo IDEZUKI: "Esophageal Varices" Geka Shinryo (Tokyo). 28. 1308-1314 (1986)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] Yasuo IDEZUKI: "Indication of endoscopic sclerotherapy" Rinsho Geka (Journal of Clinical Surgery). 41. 1373-1378 (1986)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] Kensho SANJO: "Endoscopic sclerotherapy of esophagal varices" Meicina. 23. 1428-1433 (1986)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] Kensho SANJO: "Complication of hepatic diseases in digestive tract" Digestive Medicine. 5. 482-488 (1986)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] Yasuo IDEZUKI: IGAKU SHOIN. Sclerotherapy of esophageal varices, 140 (1988)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] 出月康夫: 外科診療. 28. 1308-1314 (1986)

    • Related Report
      1986 Annual Research Report
  • [Publications] 出月康夫,三條健昌: 臨床外科. 41. 1373-1378 (1986)

    • Related Report
      1986 Annual Research Report
  • [Publications] 三條健昌,出月康夫: medicina. 23. 1428-1433 (1986)

    • Related Report
      1986 Annual Research Report
  • [Publications] 三條健昌,出月康夫: 消化器外科. 9. 1367-1375

    • Related Report
      1986 Annual Research Report
  • [Publications] 三條健昌,出月康夫: 消化器科. 5. 482-488 (1986)

    • Related Report
      1986 Annual Research Report
  • [Publications] 川崎誠治,三條健昌,出月康夫: 外科診療. 28. 1013-1017 (1986)

    • Related Report
      1986 Annual Research Report
  • [Publications] 出月康夫: "食堂静脈瘤の診かたと治療" 医学書院, 294 (1986)

    • Related Report
      1986 Annual Research Report

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Published: 1987-03-31   Modified: 2016-04-21  

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