Partial splenic embolization combined with endoscopic sclerotherapy for severe esophageal varicosity

Objective: To evaluate the therapeutic efficacy of partial splenic embolization (PSE) combined with endoscopic sclerotherapy (EIS) in treating severe esophageal varicosity. Methods: During the period from June 2009 to Feb. 2011, a total of 68 patients with severe esophageal varicosis cause by cirrhosis were admitted to authors' hospital. The patients were randomly divided into group A (combination treatment group, n = 32) and group B (simple EIS group, n = 36). Patients in group A received PSE together with EIS, while patients in group B received EIS only. For patients in group A PSE was first carried out, which was followed by EIS (injection of 1% lauromacrogol), while for patients in group B only EIS was employed. Gastric endoscopy was performed in all patients within 12 months after the treatment. The times of endoscopic sclerotherapy needed for a radical cure of varicosis and the total amount of sclerosis agent used in procedures were recorded. The results were analyzed. Results: To obtain a radical cure of varicosis the mean times of endoscopic sclerotherapy for patients of group A and group B were 1.5 and 2.7 respectively. The total amount of sclerosis agent used for patients of group A and group B were 38 ml and 94 ml respectively. Conclusion: In treating severe esophageal varicosis cause by cirrhosis, PSE combined with EIS is obviously superior to simple EIS. (authors)