Prevention of liver puncturing tract bleeding occurring after percutaneous transhepatic gastroesophageal varices embolization

Objective: To discuss the preventive measures for liver puncturing tract bleeding occurring after percutaneous transhepatic gastroesophageal varices embolization (PTVE). Methods: A total of 112 cases with variceal bleeding from esophagus and gastric fundus due to cirrhosis were enrolled in this study. PTVE was carried out in all patients. After PTVE, gelatin sponge strips (n=58) or metal coils (n= 54) were used to fill the puncturing tract in order to prevent postoperative intra-abdominal hemorrhage. The clinical results were analyzed. Results: Filling of puncturing tract with gelatin sponge strips or metal coils was performed in all patients. During the procedure the coil dropped into the hepatic vein in one case, which then went into a small branch of' the left pulmonary artery. During the follow-up period no liver puncture-related intra-abdominal hemorrhage occurred. Conclusion: For the prevention of intra-abdominal hemorrhage after PTVE, filling of puncturing tract with gelatin sponge strips oi metal coils is technically simple and clinically effective. Therefore, this technique should be recommended in clinical practice. (authors)