Diagnostic and therapeutic esophagogastroduodenoscopy in patients on the waiting list for liver transplantation

Abstract

Objective: to assess the results of the treatment and prevention of hemorrhage from the esophageal varices (EV) in patients on the waiting list (WL) for liver transplantation (LT).Subjects and methods. Twenty-seven patients with portal hypertension-complicated hepatic cirrhosis of various etiologies were treated at the N.V. Sklifosovsky Research Institute of Emergency Care in 2005 to 2010. All the patients were placed on the LT WL on the basis of clinical and instrumental studies. In addition to esophagogastroduodenoscopy (EGD), a set of instrumental studies comprised abdominal ultrasonography and dynamic and static liver scintigraphy.Results and discussion. Diagnostic EGD revealed grade 3 EV in all the 27 patients. There was a rather high rate of not only erosive gastroduodenitis, but also duodenal ulcer (22.2%).Conclusion. Diagnostic and therapeutic EGD in patients with severe portal hypertension can diagnose esophageal varix and a number of concomitant abnormal changes and apply a set of mini-invasive methods to arrest and prevent esophagogastrointestinal hemorrhage.

Keywords

• portal hypertension
• liver scintigraphy
• esophagogastroduodenoscopy
• endoscopic ligation
• infiltration hemostasis