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Endoscopic Treatment of Esophageal Varices: Suzuki Method

  • Hiroaki Suzuki
  • Manabu YamamotoEmail author
Chapter

Abstract

The Suzuki method was established in 1979 and is a unique intra- and para-variceal combined injection technique using 1% polidocanol (Aethoxysclerol).

From 1979 to 1987, we performed this procedures a total 878 times on 276 patients. There were 94 emergency, 92 elective, and 90 prophylactic cases.

We use Aethoxysclerol as the safest sclerosant since it has low toxicity and low viscosity. The injections are first made into a submucosal site between the varices and then into each variceal channel, using 3 mL in each injection. The total dose of sclerosant is limited to 30 mL per one session of therapy. We perform the endoscopic injection sclerotherapy (EIS) by freehand technique without any sheath or balloon, using a flexible 23 or 25 gauge fine needle under intravenous sedation and topical anesthesia. As a rule, three sessions of EIS are performed at weekly intervals, and a follow-up study is done every 3 months for choosing additional therapy or observation.

As a result, the hemostatic rate was as high as 91% and the eradicating rate was 92%.

The Suzuki method is an effective treatment for both acute variceal bleeding and bleeding prophylaxis.

Keywords

EIS Esophageal varices Endoscopic sclerotherapy Aethoxysclerol Polidocanol 

References

  1. 1.
    Nagao F, Suzuki H. Drug therapy for gastrointestinal bleeding (in Japanese). Surg Diagn Treat. 1980;22:1127–32.Google Scholar
  2. 2.
    Suzuki H, Kohyama M, Nagata T, Watanabe Y, Nagao F. Endoscopic sclerotherapy for the control of bleeding from esophageal varices. In: Okabe H, Honda T, Ohshiba S, editors. Endoscopic surgery. Amsterdam: Excerpta Medica; 1984. p. 23–30.Google Scholar
  3. 3.
    The Japan society for portal Hypertension. The general rules for study of portal hypertension (in Japanese). 3rd ed. Tokyo: Kanehara & Co., Ltd; 2013.Google Scholar
  4. 4.
    Westaby D, Williams R. Injection sclerotherapy for the long-term management of variceal bleeding. World J Surg. 1984;8:667–72.CrossRefGoogle Scholar
  5. 5.
    Terblanche J, Bornman PC, Kahn D, Kirsh RE. Sclerotherapy in acute variceal bleeding: technique and results. Endoscopy. 1986;18:23–7.CrossRefGoogle Scholar
  6. 6.
    Williams KGD, Dawson JL. Fibreoptic injection of oesophageal varices. Br Med J. 1979;2:766–7.CrossRefGoogle Scholar
  7. 7.
    Takase Y, Ozaki A, Orii K, et al. Injection sclerotherapy of esophageal varices for patients undergoing emergency and selective surgery. Surgery. 1982;92:474–6.PubMedGoogle Scholar
  8. 8.
    Stiegmann GV. Fifteen years of endoscopic variceal ligation for bleeding esophago- gastric varices. Endoscopia Digestiva. 2001;13:1253–61.Google Scholar
  9. 9.
    Suzuki H. Endoscopic variceal ligation. Asian Med J. 1988;42:362–6.Google Scholar
  10. 10.
    Suzuki H, Yamamoto M, Chibai M. Endoscopic injection sclerotherapy for gastric varices. Prog Dig Endosc. 1988;33:83–6.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of EndoscopyJikei University School of MedicineTokyoJapan
  2. 2.Adachi Kyosai HospitalTokyoJapan

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