胃静脈瘤に対するTransileocolic vein obliteration(TIO)の検討

Seven cases of giant gastric varices were treated using TIO combined with balloon occlusion of the gastro-renal shunt, for the purpose of reviewing the significance of TIO in the treatment of gastric varices.
In 6 of the 7 cases, giant varices were cured completely. In the unsuccessful case, it was a giant varix (the minimum diameter was 25 mm or more) which had been failed to be treated by the TIO. In 3 of the 7 cases, the varices on the gastric fornix had ruptured ; therefore, emergency TIO was undertaken and resulted in successful hemostasis and disappearance of the varices.
After treatment using this technique, one case developed esophageal varices, and two patients showed a reduction in esophageal varices. In case where gastric varices had been accompanied by RC sign-positive esophageal varices, favorable results were obtained with obliteration of the gastro-renal shunt was combined with compression of the esophagus which had served as another shunt in these cases. After TIO, hepatic function remained unchanged or improved slightly. No case showed exacerbation of hepatic function.
For massive gastric varices with an inside diameter of up to 2 cm, transileocolic vein obliteration (TIO) combined with balloon occlusion of the gastro-renal shunt, which occludes the shunt in an anterograde manner, secures the occlusion of the shunt with no complications. This technique seems to be an effective therapy for gastric varices.