Consecutive approach in treatment of resistant bleeding from esophageal varices
Abstract
Prevention of the development of esophageal and gastric varices and its progression, prevention of the first episode of bleeding, hemostasis in acute bleeding, as well as the prevention of repeated episodes of bleeding are the main directions of the treatment strategy in patients with portal hypertension.Analysis of the results of open esophagogastric devascularization with esophageal transection followed by endoscopic hemostasis and transjugular portosystemic shunting for persistently recurrent bleeding from esophageal varices.Open esophagogastric devascularization with esophageal transection followed by endoscopic hemostasis and transjugular portosystemic shunting for persistent recurrence of bleeding from esophageal varices were performed in Grodno Regional Clinical Hospital in October 2018. The operations were performed in a 56-year-old patient with liver cirrhosis of mixed etiology (viral hepatitis B and C plus alcohol), Child-Pugh class B, complicated by portal hypertension and recurrent bleeding from esophageal varices. The use of sequential approach in the treatment of repeatedly relapsing bleeding from esophageal varices contributed to the achievement of stable hemostasis and the absence of recurrence of bleeding from esophageal varices in the postoperative period. The follow-up period after surgery was 8 months; no recurrence of bleeding was noted during this period.The use of a combined sequential approach using open esophagogastric devascularization, endoscopic hemostasis and transjugular portosystemic shunting is effective in the treatment of repeatedly recurring episodes of hemorrhages from esophageal varices with the aim of finally stopping bleeding.
About the Authors
E. V. Mahiliavets
УО «Гродненский государственный медицинский университет»
Russian Federation
Russian Federation
L. F. Vasilchuk
Гродненская университетская клиника
Russian Federation
Russian Federation
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Review
For citations:
Mahiliavets E.V., Vasilchuk L.F. Consecutive approach in treatment of resistant bleeding from esophageal varices. Medical and Biological Problems of Life Activity. 2020;(1):123-134. (In Russ.)
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