Clinical Study on the Timing of Emergency Gastroscopy in Liver Cirrhotic Patients with Esophageal Variceal Bleeding

Abstract

Esophageal variceal bleeding is a common complication of liver cirrhosis，and gastroscopic therapy has gradually become a significant clinical treatment for it. However, the timing of treatment with gastroscopy in liver cirrhotic patients with upper gastrointestinal bleeding is still controversial. In this study, 138 cases of liver cirrhotic patients with esophageal hemorrhage were retrospectively analyzed and followed up. Patients were divided into 4 groups based on whether they underwent gastroscopy and the first timing of gastroscopy, including group A with emergency gastroscopy within 12 hours, group B with emergency gastroscopy within 12-24 hours, group C with emergency gastroscopy within 24-48 hours and group D with conservative treatment. Gastroscopy at different time points and results of treatment were analyzed ,and the bleeding detection rate, success rate of hemostasis, early recurrent bleeding rate, mortality rate within a year and average hospital stay were followed up in order to further explore the best time-window and value of treatment in liver cirrhotic patients with esophageal variceal bleeding by emergency gastroscopy. The results of this study showed that the success rate of hemostasis, mortality rate within a year and average hospital stay of patients in group B were superior than that of group A, C and D. This study also demonstrates that emergency gastroscopy can effectively reduce the early recurrent bleeding rate, mortality rate within a year and average days in hospitalization in liver cirrhotic patients with esophageal variceal bleeding, but have no effect on the success rate of hemostasis. This study indicates that emergency gastroscopy is an efficient and effective method to diagnose and treat liver cirrhotic patients with esophageal variceal bleeding at present, and the best time-window of treatment with emergency gastroscopy should be within 12h-24h after admission.