EVALUATION OF SAFETY AND EFFICACY OF ARGON PLASMA COAGULATION IN TREATMENT OF PORTAL HYPERTENSIVE GASTROPATHY IN EGYPTIAN PATIENTS WITH LIVER CIRRHOSIS
Mohamed El-Nadry*, Ali Ibrahim Ali1, Waleed M. Mousa, Diaa M. EL-Tiby, Mostafa Elhawary, Ismail A. Sakr
Background: Portal hypertensive gastropathy (PHG) occurs as a complication of cirrhosis or non-cirrhotic portal hypertension. Endoscopic ablation of PHG is gaining popularity nowadays. Argon plasma coagulation (APC) is a non contact thermal method of hemeostasis. Aim of the work: The study aimed to evaluate the efficacy and safety of APC as a tool of management of patients with severe portal hypertensive gastropathy due to liver cirrhosis. Methods: A prospective study was conducted from the period between January 2017 to July 2017 on 30 persons who fulfilling the designed inclusion criteria. Cirrhotic patients were prospectively included in this study if they presented with overt or occult bleeding related to portal hypertension. Success was defined as; control of bleeding, or significant Hb increase from pretreatment level, All patients were subjected to full history taking, through clinical examination, routine laboratory investigations, Occult blood in stool, abdominal ultrasound, and upper GIT endoscopy. Results: All patients had severe portal hypertensive gastropathy, 19 patients (63.3 %) had their lesions in the body and fundus, 5 patients (16.7 %) had their lesions in the body, fundus and antrum, 4 patients (13.3 %) had their lesions in the body and 2 patients (6.7 %) had their lesions in the fundus only. APC was done for 30 patients with severe PHG and followed in serial sessions (3 - 4 weeks interval) up to 3 sessions and duration of follow up was 6 months, 22 patients (73.3 %) of severe PHG changed into mild form of PHG. Conclusion: APC is effective and safe in the treatment of cirrhosis-related severe portal hypertensive gastropathy and our study suggests that APC should be considered as the treatment of choice in severe portal hypertensive gastropathy.
Keywords: Argon plasma coagulation, cirrhotic patients, Portal hypertensive gastropathy.
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