The factor analysis of the results of modern treatment of patients with liver cirrhosis with portal hypertension

Abstract

The purpose of this study is to study and evaluate the results of conventional methods of endovascular and endoscopic treatment of patients with complicated portal hypertension. Methods. In our study until 2021, 56 patients were included for analysis. In the course of the research, in 12 cases the endovascular method of percutaneous hepatic embolization of esophagus and gastric varicose vein in combination with splenic artery embolization, endoscopic sclerotherapy method in 23 cases, and endoscopic ligation according to the traditional method in 21 cases were used. The result of research work has showed that isolated use of endovascular methods (left gastric vein embolization, splenic artery embolization) in patients with liver cirrhosis is characterized by a low 2-year survival rate - 14.2%, with frequent anatomical and technical complications of this procedure - up to 64.7%, unstable primary hemostasis – 40.4%, esophagus and gastric varicose vein are explained by a high rate of recurrence of bleeding from varicose veins – 67.4%, risk of death – 21.8%. Conclusions. The clinical advantages of EL compared to different methods of ES have been achieved in terms of the rate of ineffective primary hemostasis, the risk of recurrence of bleeding from EGVV, short-term and long-term results, as well as improved 2-year survival rates. However, in general, their isolated use is associated with a relatively low chance of complete prevention of exacerbation of hemorrhagic syndrome relapses, which makes it possible to choose a combined approach to the treatment of patients with LC with PH and risk of bleeding from EGVV requires the development of tactical algorithms. In endovascular transhepatic embolization of esophageal and gastric varices, good results of treatment in the follow-up period of up to 2 years were very low, while unsatisfactory results of ES prevailed over good results, in turn, the best results were observed in the EL group. The results of endovascular transhepatic embolization in EGVV remain unknown in 1/3 of the studies.