Anesthetic aspects of management and control of portal hypertension during endoscopic esophageal varices ligation

This article provides original method of portal hypertension control in patients with liver cirrhosis during endoscopic variceal ligation under moderate sedation. This method helps to lower the risk of variceal bleeding during the ligation.Clinical experience of combined perioperative arterial and venous pressure monitoring in 141 intervention group patients and in 12 control group patients with national surgical society premedication was analysed. All of these patients had portal hypertension of various etiology complicated by esophageal varices, which were treated by endoscopic ligation.Performance of endoscopic variceal ligation in patients with liver cirrhosis (class B and C) complicated by variceal bleeding under anesthesia with Harvard standard monitoring, endoscopic balloon esophagomanometry and additional controlled hypotension with nitroglycerin has provided better control over arterial and portal venous pressure and lowered postoperative bleeding rate from 33,6% to 1,9%.