Advertisement

Leberzirrhose und portale Hypertension

  • H. Seifert
  • U. Leuschner

Zusammenfassung

Das gemeinsame Endstadium der meisten chronischen Leberkrankheiten ist die Leberzirrhose. Eine medikamentöse Therapie der Zirrhose selbst gibt es nicht, behandeln lassen sich nur ihre Komplikationen, wie Pfortaderhochdruck, Aszites und hepatische Enzephalopathie. Neben der endoskopischen und medikamentösen Therapie steht die operative Behandlung.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Angelico M, Carli L, Piat C, et al., (1993) Isosorbide-5-mononitrate versus propranolol in the prevention of first bleeding in cirrhosis. Gastroenterology 104:1460–1465PubMedGoogle Scholar
  2. Besson I, Ingrand P, Person B, et al., (1995) Sclerotherapy with or without octreotide for acute variceal bleeding. N Engl J Med 333:555–560PubMedCrossRefGoogle Scholar
  3. Brocchi E, Caletti G, Brambilla G, et al., (1988) Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. N Engl J Med 319:983–989CrossRefGoogle Scholar
  4. Conn HO, Rambsby GR, Storer EH, et al., (1975) Intraarterial vasopressin in the treatment of upper gastrointestinal hemorrhage: a prospective controlled clinical trial. Gastroenterology 68:211–221PubMedGoogle Scholar
  5. D’Amico G, Pagliaro L, Bosch J (1995) The treatment of portal hypertension: a meta-analytic review. Hepatology 22:332–354CrossRefGoogle Scholar
  6. Feretis C, Dimopoulos C, Benakis P, et al., (1995) N-Butyl-2-cyanoacrylate (Histoacryl) plus sclerotherapy versus sclerotherapy alone in the treatment of bleeding esophageal varices: a randomized prospective study. Endoscopy 27:355–357PubMedCrossRefGoogle Scholar
  7. Grace ND (1992) Prevention of initial variceal hemorrhage. Gastroenterol Clin North Am 21:149–161PubMedGoogle Scholar
  8. Hashizume M, Kitano S, Koyanagi N, et al., (1992) Endoscopic injection sclerotherapy for 1000 patients with esophageal varices: A nine-year prospective study. Hepatology 15:69–75PubMedCrossRefGoogle Scholar
  9. Jutabha R, Jensen DM, See J, et al., (1995) Randomized, controlled study of various agents for endoscopic injection sclerotherapy of bleeding canine gastric varices. Gastrointest Endosc 41:206–211PubMedCrossRefGoogle Scholar
  10. Kitano S, Terblanche J, Kahn D, et al., (1986) Venous anatomy of the lower oesophagus in portal hypertension: practical implication. Br J Surg 73:525–531PubMedCrossRefGoogle Scholar
  11. Kleber G, Sauerbruch T, Ansari H, et al., (1991) Prediction of variceal hemorrhage in cirrhosis: A prospective follow-up study. Gastroenterology 100:1332–1337PubMedGoogle Scholar
  12. Lebrec D, Poynard T, Hillon P, et al., (1981) Propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis. N Engl J Med 305:1371–1374PubMedCrossRefGoogle Scholar
  13. Orlof MJ, Orloff MS, Orloff SL, et al., (1995) Treatment of bleeding from portal hypertensive gastropathy by portocaval shunt. Hepatology 21:1011–1017Google Scholar
  14. Papatheodoridis GV, Goulis J, Leandro G, et al., (1999) Transjugular intrahepatic portosystemic shunt compared with endoscopie treatment for prevention of variceal rebleeding: a meta-analysis. Hepatology 30:612–622PubMedCrossRefGoogle Scholar
  15. Rigo GP, Merighi A, Chahin NJ, et al., (1992) A prospective study of the ability of three endoscopie classifications to predict hemorrhage from esophageal varices. Gastrointest Endosc 38:425–429PubMedCrossRefGoogle Scholar
  16. Sarin SK, Lamba GS, Kumar S, et al., (1999) Comparison of endoscopie ligation and propranolol for the primary prevention of variceal bleeding. N Engl Med 340:988–993CrossRefGoogle Scholar
  17. Sato T, Yamazaki K, Toyota J, et al., (1999) Evaluation of magnetic resonance angiography in detection of gastric varices. J Gastroenterol 34:321–326PubMedCrossRefGoogle Scholar
  18. Seifert H, Schmitt T, Gültekin T, Caspary WF, Wehrmann T (2000) Synergistic sedation with propofol plus midazolam vs. sedation with propofol alone for interventional endoscopie procedures: a randomized prospective study. Aliment Pharmacol Ther (im Druck)Google Scholar
  19. Silverstein FE, Tytgat GNJ (Hrsg) (1994) Gastroenterologische Endoskopie. Thieme, StuttgartGoogle Scholar
  20. Soehendra N, Nam VC, Grimm H, Kempeneers I (1986) Endoscopie obliteration of large esophageal varices with bycrylate. Endoscopy 18:25–26PubMedCrossRefGoogle Scholar
  21. Spina GP, Arcidiacono R, Bosch J, et al., (1994) Gastric endoscopic features in portal hypertension: final report of a consensus conference, Milan, Italy, September 19, 1992. J Hepatol, 21:461–467PubMedCrossRefGoogle Scholar
  22. Stiegmann GV, Goff JS, Michaletz-Onody PA, et al., (1992) Endoscopic sclerotherapy as compared with endoscopie ligation for bleeding esophageal varices. N Engl J Med 326:1527–1532PubMedCrossRefGoogle Scholar
  23. Svoboda P, Kantorova I, Ochmann J, Kozumplik L, Marsova J (1999) A prospective randomized controlled trial of sclerotherapy vs ligation in the prophylactic treatment of high-risk esophageal varices. Surg Endoscopy 13:580–584CrossRefGoogle Scholar
  24. Thakeb F, Salama Z, Raouf TA, et al., (1995) The value of combined use of N-butyl-2-cyanoacrylate and ethanolamine oleate in the management of bleeding oesophagogastric varices. Endoscopy 27:358–364PubMedCrossRefGoogle Scholar
  25. The North Italian Endoscopie Club for the Study and Treatment of Esophageal Varices (1988): Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A protective multicenter study. N Engl J Med 319:983–989CrossRefGoogle Scholar
  26. Vianna A, Hayes PC, Moscoso G, et al., (1987) Normal venous circulation of the gastroesophageal junction: A route to understanding varices. Gastroenterology 93:876–889PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • H. Seifert
  • U. Leuschner

There are no affiliations available

Personalised recommendations