Clinical diagnosis of hepatocellular carcinoma complicated with esophageal and gastric variceal bleeding

Abstract

Abstract: Objective To investigate the clinical characteristics and diagnosis of gastroesophageal variceal hemorrhage (GEVH) of patients with hepatocellular carcinoma (HCC), and to evaluate the efficacy and safety of patient-oriented endoscopic therapy for GEVH. Methods The clinical characteristics, patient-oriented endoscopic therapy efficacy, and prognosis of 40 HCC patients with GEVH from the Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between January 2013 and December 2023 were retrospectively studied. Results Most of the patients (38/40) had a poor liver function, among which 90.0% of the patients were Child-Turcotte-Pugh grade B and C, and most patients were with severe initial bleeding. 77.5% of the patients had hematemesis. The initial patient-oriented endoscopic therapy was mainly endoscopic variceal ligation (EVL) (82.5%), and the patients′ bleeding symptoms were all controlled after endoscopic therapy. Twenty-two patients continued the follow-ups after the first endoscopic therapy, with an average follow-up duration of 37 months. Only 3 patients had rebleeding symptoms at the last follow-up, without serious complications during the follow-ups. Conclusion Endoscopic diagnosis and patient-oriented endoscopic therapy for HCC with GEVH are effective and safe, which may prolong the patients’ survival and improve the patients’ quality of life.

Key words: Gastroesophageal variceal hemorrhage, Hepatocellular carcinoma, Endoscopic therapy

GU Lei-lei, CHEN Ping, WU Yun-lin. Clinical diagnosis of hepatocellular carcinoma complicated with esophageal and gastric variceal bleeding[J]. Chinese Hepatolgy, 2025, 30(11): 1475-1477.

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