| Theme |
Treatment for Portal Hypertension : Update |
| Title |
Current Topics Concerning Endoscopic Injection Sclerotherapy (EIS) for Esophageal Varices |
| Author |
Shinichi Nakamura |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Kana Yamamoto |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Ichiro Ishikawa |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Maiko Kishino |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Hiroyuki Konishi |
Institute of Gastroenterology, Tokyo Women's Medical University |
| Author |
Keiko Shiratori |
Institute of Gastroenterology, Tokyo Women's Medical University |
| [ Summary ] |
In Japan, endoscopic injection sclerotherapy (EIS) employing intravariceal technique, was introduced and became an accepted procedure 30 years ago. The natural history of esophageal varices has improved with the implementation of EIS. Intravariceal EIS using 5 % ethanolamine oleate (5 % EO) has a strong effect in terms of obliterating esophageal varices and their supply vessels. At the present time, endoscopic variceal ligation (EVL) is widely performed as an endoscopic treatment for esophageal varices, because of reduced invasiveness and complications. If therapeutic results are similar with EIS or EVL, EVL should be selected. In relation to the hemodynamics observed with endoscopic ultrasonography (EUS) and 3D-CT angiography before treatment, the proper procedure should be chosen for individual cases. EIS should be performed for cases where it is necessary to obliterate the supply vessels fully, this making the primary objective of EIS use. EIS has become the mainstay of treatment for esophageal varices. Endoscopists must acquire a high degree of technical skills in order to implement this procedure. |