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(surgery) tying a duct or blood vessel with a ligature (as to prevent bleeding during surgery)

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1. 内視鏡的静脈瘤結紮術 endoscopic variceal ligation
2. 急性静脈瘤出血患者における止血法 methods to achieve hemostasis in patients with acute variceal hemorrhage
3. 静脈瘤出血のマネージメントの一般原則 general principles of the management of variceal hemorrhage
4. Cystic fibrosis: Hepatobiliary disease
5. 肝硬変患者における静脈瘤出血に対する一次予防および静脈瘤形成予防 primary and pre primary prophylaxis against variceal hemorrhage in patients with cirrhosis

English Journal

Green tea polyphenol decreases the severity of portosystemic collaterals and mesenteric angiogenesis in rats with liver cirrhosis.

Hsu SJ, Wang SS, Hsin IF, Lee FY, Huang HC, Huo TI, Lee WS, Lin HC, Lee SD.AbstractAbnormal angiogenesis in liver cirrhosis often leads to severe complications such as variceal haemorrhage and encephalopathy. Furthermore, splanchnic angiogenesis elevates portal pressure, in which angiogenic factors play pivotal roles. GTP (green tea polyphenol) extracted from Camellia sinensis has anti-angiogenic properties, but the effects on the parameters described above in cirrhosis have not been investigated. The aim of the present study was to determine the effects of GTP in cirrhosis and to investigate the underlying mechanism. Liver cirrhosis was induced in Spraque-Dawley rats by common BDL (bile duct ligation). They randomly received GTP or DW (distilled water, vehicle) for 28 days, then haemodynamic parameters, portosystemic shunting, mesenteric window vascular density, intrahepatic angiogenesis, liver fibrosis, plasma VEGF (vascular endothelial growth factor) concentration, mesenteric angiogenic factor and receptor protein expression, and serum and mesenteric oxidative stress parameters were assessed. Compared with the DW group, GTP significantly decreased portosystemic shunting, liver fibrosis, intrahepatic angiogenesis, mesenteric window vascular density, VEGF concentration and down-regulated the mesenteric HIF (hypoxia-inducible factor)-1α, VEGF and phospho-Akt expression. In conclusion, GTP ameliorates the severity of portosystemic shunting and mesenteric angiogenesis via the suppression of HIF-1α, Akt activation and VEGF. GTP appears to be an appropriate agent in controlling portal hypertension-related complications via anti-angiogenesis.
Clinical science (London, England : 1979).Clin Sci (Lond).2014 May 1;126(9):633-44. doi: 10.1042/CS20130215.
Abnormal angiogenesis in liver cirrhosis often leads to severe complications such as variceal haemorrhage and encephalopathy. Furthermore, splanchnic angiogenesis elevates portal pressure, in which angiogenic factors play pivotal roles. GTP (green tea polyphenol) extracted from Camellia sinensis has
PMID 24063570

The safety of combined sedation with propofol plus fentanyl for endoscopy screening and endoscopic variceal ligation in cirrhotic patients.

Mao W1, Wei XQ, Tao J, Zhen FP, Wen ZF, Wu B.Author information 1Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China.AbstractOBJECTIVE: We aimed to investigate the safety of combined sedation with propofol plus fentanyl in patients with liver cirrhosis during screening esophagogastroduodenoscopy (SEGD) and a secondary prophylaxis for esophageal varices, endoscopic gastrointestinal ligation (EVL).
Journal of digestive diseases.J Dig Dis.2014 Mar;15(3):124-30. doi: 10.1111/1751-2980.12115.
OBJECTIVE: We aimed to investigate the safety of combined sedation with propofol plus fentanyl in patients with liver cirrhosis during screening esophagogastroduodenoscopy (SEGD) and a secondary prophylaxis for esophageal varices, endoscopic gastrointestinal ligation (EVL).METHODS: A total of 309 pa
PMID 24224839

Impact of portal vein thrombosis on the efficacy of endoscopic variceal band ligation.

Dell'era A1, Iannuzzi F2, Fabris FM3, Fontana P2, Reati R2, Grillo P4, Aghemo A5, de Franchis R2, Primignani M3.Author information 1Department of Medical Sciences, Università degli Studi di Milano - IRCCS Fondazione Cà Granda Ospedale Policlinico di Milano, Milan, Italy; Gastroenterology 3 Unit - IRCCS Fondazione Cà Granda Ospedale Policlinico di Milano, Milan, Italy. Electronic address: alessandra.dellera@unimi.it.2Department of Medical Sciences, Università degli Studi di Milano - IRCCS Fondazione Cà Granda Ospedale Policlinico di Milano, Milan, Italy; Gastroenterology 3 Unit - IRCCS Fondazione Cà Granda Ospedale Policlinico di Milano, Milan, Italy.3Gastroenterology 3 Unit - IRCCS Fondazione Cà Granda Ospedale Policlinico di Milano, Milan, Italy.4Epidemiology Unit - IRCCS Fondazione Cà Granda Ospedale Policlinico di Milano, Milan, Italy.5Gastroenterology 1 Unit - IRCCS Fondazione Cà Granda Ospedale Policlinico di Milano, Milan, Italy.AbstractBACKGROUND: Influence of portal vein thrombosis on efficacy of endoscopic variceal banding in patients with cirrhosis or extrahepatic portal vein obstruction has never been evaluated. Aim of the study was to assess influence of thrombosis on rate and time to eradication in cirrhosis and extrahepatic portal vein obstruction undergoing banding, compared to cirrhotic patients without thrombosis.
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.Dig Liver Dis.2014 Feb;46(2):152-6. doi: 10.1016/j.dld.2013.08.138. Epub 2013 Sep 29.
BACKGROUND: Influence of portal vein thrombosis on efficacy of endoscopic variceal banding in patients with cirrhosis or extrahepatic portal vein obstruction has never been evaluated. Aim of the study was to assess influence of thrombosis on rate and time to eradication in cirrhosis and extrahepatic
PMID 24084343

Japanese Journal

硬化療法後に虚血性胃粘膜病変をきたした残胃静脈瘤破裂の1例

菊池哲,井上義博,藤野靖久,小野寺誠,小豆嶋立頼,近藤公亮,遠藤重厚
日本消化器内視鏡学会雑誌 55(7), 1995-1999, 2013
症例は76歳男性，主訴は吐血．十二指腸潰瘍のため40歳時Billroth I法再建術施行歴のある患者．近医市中病院で残胃静脈瘤破裂と診断され，内視鏡的静脈瘤結紮術施行後ショック状態となり当科へ紹介．同日75％Cyanoacrylateによる内視鏡的硬化療法を施行した．翌日の内視鏡検査では止血状態であることを確認したが，残胃体部小彎から吻合部まで充血したびらん性胃粘膜が連続し，CA注入部の静脈瘤周囲 …
NAID 130003375328

部分的脾動脈塞栓術を併用した内視鏡的硬化療法が有効であった肝外門脈閉塞症に合併した治療抵抗性食道静脈瘤の1例

石橋啓如,阿部宏美,宮川明祐,松島知広,秦佐智雄,中村朗,紫村治久,糸林詠,志村謙次,横須賀收
日本消化器内視鏡学会雑誌 55(6), 1848-1853, 2013
症例は46歳男性，2年前に食道静脈瘤破裂を契機に一次的肝外門脈閉塞症と診断．以後計4回の静脈瘤破裂に対して内視鏡的静脈瘤結紮術が繰り返し施行されたが，短期間にて再発した．腹部造影CTでは肝門部の海綿状血管増生，脾腫を認め，発達した脾静脈は上腸間膜静脈と交通せずに左胃静脈を介して静脈瘤へと連続し，いわゆる左側門脈圧亢進症を呈していた．内視鏡治療単独では制御困難と考え，5％ ethanolamine …
NAID 130003375316

十二指腸静脈瘤破裂に対するダブルバルーン内視鏡を用いた内視鏡的静脈瘤結紮術の経験

會澤信弘,岩田恵典,高嶋智之,坂井良行,榎本平之,河野友影,中村志郎,松本譽之,三輪洋人,西口修平
日本消化器内視鏡学会雑誌 55(4), 1478-1483, 2013
症例は72歳男性で，タール便を主訴に入院となった．非代償期C型肝硬変と肝細胞癌にて経過観察されていた．食道静脈瘤に対し6年前に内視鏡的静脈瘤硬化療法を行った．肝細胞癌に対し計7回肝動脈化学塞栓療法（TACE）を行った．腹部造影CTにて十二指腸周囲に静脈瘤を認めた．上部消化管内視鏡検査にて十二指腸水平部に白色栓を伴う腫瘤状の静脈瘤を認めた．この静脈瘤に対し，ダブルバルーン内視鏡を用いて内視鏡的静脈瘤 …
NAID 130003375282