Results of application of modified technique of esophageal varices ligation in patients with liver cirrhosis combined with hepatocellular carcinoma

Objective. Analysis of the results of using a modified technique of endoscopic ligation in primary and secondary prevention of bleeding from varicose veins (VV) of the esophagus in patients with liver cirrhosis combined with hepatocellular carcinoma. Material and methods. The study included 42 patients with liver cirrhosis and hepatocellular carcinoma who underwent treatment from 2019 to 2023. The technique is based on the principle of «1 ring per 1 venous trunk» to reduce the risk of bleeding and sclerotic changes in the esophagus. Results. In the study group, the incidence of complications in the form of hyperthermia in the early postoperative period was 9.5% (4 patients). No intraoperative complications were noted. No episodes of bleeding in the early and late postoperative periods were recorded. Dysphagia was observed in 7 (16.7%) patients. The severity of esophageal varices of grade I 1 month after the modified endoscopic ligation technique was observed in 29 (85.3%) patients, and grade II — in 5 (14.7%). Repeated endoscopic ligation of esophageal varices after 1 month was performed in 2 (5.9%) patients in the study group. Mortality 1 month after surgery was 19.1% (8 patients died), associated with the progression of the underlying disease. Conclusion. The modified technique of endoscopic ligation of esophageal varices can be used as a palliative intervention in patients with liver cirrhosis combined with hepatocellular carcinoma for the purpose of primary and secondary prevention of bleeding, ensuring a low incidence of postoperative complications.