Clinical efficacy of endoscopic esophageal variceal ligation in elderly patients with hepatic cirrhosis

Abstract

Objective To evaluate the clinical efficacy of endoscopic esophageal variceal ligation (EVL) for esophageal variceal bleeding (EVB) in elderly patients with hepatic cirrhosis. Methods From July 2007 to July 2013, clinical data of 198 patients who had been diagnosed with liver cirrhosis presenting with EVB were retrospectively analyzed.Among them, 167 patients who had received EVL were divided into the elderly EVL group (n=97, age≥60 years) and the non-elderly EVL group (n=70, aged<60 years). The other 31 cases (aged≥ 60 years) had received propranolol therapy.Treatment effectiveness, adverse effects, complications and the one-year survival rate of each group were analyzed. Results The efficacy rates and variceal recurrences were 77.3% (75/97) and 78.6% (55/70) in the elderly EVL group and 19.6% (19/97) and 18.6% (13/70) in the non-elderly EVL group, respectively, with no significant difference between the two groups (each P>0.05). The re-bleeding rate was higher in the propranolol treatment group than in the elderly and non-elderly EVL groups 〔58.1%(18/31)vs.24.7%(24/97)vs, 22.9%(16/70), χ2=14.76, P=0.00〕. One-year survival rates in the elderly group, the non-elderly EVL group and the propranolol treatment group were 86.6 (84/97), 88.6% (62/70), 64.5% (20/31), respectively, with statistically significant differences between the three groups (χ2=10.24, P=0.01). Conclusions EVL is effective for the treatment of hepatic cirrhosis with EVB and can be used as a secondary prophylaxis measure for EVB in elderly patients with hepatic cirrhosis. Key words: Endoscopic and gastric variceas; Liver cirrhosis