Efficacy of different methods for preventing gastroesophageal bleeding in patients with liver cirrhosis: comparative analysis

Abstract

Aim. To assess the clinical efficacy of preventing gastroesophageal bleeding in patients with liver cirrhosis.Materials and methods. From 2008 to 2019, the surgical treatment of 710 patients with cirrhosis was considered. The long-term results of preventing gastroesophageal variceal rebleeding were studied in three groups of patients: portosystemic shunt placement (367 patients), total esophagogastric disconnection (62 patients), and endoscopic procedures (281 patients). Observation periods varied from 1 to 115 months.Results. The lowest rebleeding rate of 15.5% was observed following shunt placement (χ2 = 9.728; df = 2; р = 0.008), while the highest rate of 40.9% was observed following endoscopic treatment. By the 5th year of follow-up, only 37.5% of patients showed no signs of bleeding following endoscopic procedures. The percentage of patients who did not experience true gastroesophageal variceal rebleeding amounted to 44%, 76%, and 85% following shunt placement, total esophagogastric disconnection, and endoscopic procedures, respectively (p < 0.05).Conclusion. Irrespective of the selected procedure, all patients with cirrhosis suffer from portal rebleeding in the longterm period. However, the lowest rebleeding rate is observed following portosystemic shunt placement.