3213: Use of miniature probe ultrasonography in assessing the lower esophageal veins before and after endoscopic variceal ligation plus Hassab’s procedure

Abstract

Objectives: To assess the efficacy of different procedures by evaluating the changes of esophagus vasculatures in patients with portal hypertension by miniature probe ultrasonography(MPU). Methods: Ninety-two patients with esophageal varices were randomized to receive endoscopic variceal ligation (EVL) (54) alone, Hassab’s procedure (15) alone or their combination (23) for variceal eradication. The esophagus vasculatures were examined with endoscopy and MPU and the azygos blood flow (AzBF) measured with color Doppler ultrasonography. The changes and effect before and after treatment were evaluated. Results: After treatment, the esophageal varices were obliterated and collateral veins unchanged in patients by EVL, the esophageal varices were diminished in size and collateral veins were obliterated by Hassab’s procedure, both the esophageal varices and collateral veins were obliterated by combined procedure. The frequency of perforating veins was significantly decreased in patients by Hassab’s procedure alone and combined procedure. EVL, Hassab’s procedure and their combination decreased AzBF by 31%, 32% and 43%, respectively. During short-term follow-up, the recurrence and rebleeding rate of esophageal varices was 24.45, 100%, 5.0% and 11.1%, 23.1%, 0% , respectively. Conclusions: The combined procedure can effectively shut off the portoazygous shunt and prevent bleeding. The MPU plays a important role in evaluating the treatment effect on esophageal varices.