ANALYSIS OF TREATMENT OUTCOMES FOR BLEEDING FROM ESOPHAGEAL AND GASTRIC VARICES
Introduction. Bleeding from esophageal and gastric varices (EGV) is one of the most life-threatening complications of liver cirrhosis and portal hypertension, associated with high mortality, especially in cases of late diagnosis and advanced hepatic insufficiency.
Aim. To evaluate the clinical characteristics and treatment outcomes of patients with EGV bleeding treated at the Surgical Department of the Emergency City Hospital in Almaty from 2022 to 2024.
Materials and Methods. Тhe study included 162 patients. Clinical parameters, severity of cirrhosis (Child–Pugh score), MELD index, endoscopic classification of varices (JGES), and treatment outcomes were analyzed. Descriptive statistics, Student’s t-test, χ²-test, and one-way ANOVA were used. Odds ratios (OR) with 95% confidence intervals were calculated to assess risk factors for rebleeding. A p-value < 0.05 was considered statistically significant.
Results. Among 162 patients, males predominated (55.6%), with a mean age of 54.3 ± 11.2 years. Anemia (<70 g/L) was detected in 62.3%. II–III degree varices were diagnosed in 95.1%, and Child–Pugh classes B and C were present in 69.7%. Early ligation (<24 hours) reduced rebleeding to 2.3%, compared to 12.5% with delayed intervention (OR = 2.32); presence of red color signs (RCS) increased rebleeding risk to 17.9% (OR = 6.51). Overall mortality was 4.32%, postoperative mortality — 1.2%; all fatal outcomes occurred in patients with severe hepatic dysfunction. Conclusions. EGV bleeding remains a severe complication of cirrhosis requiring prompt diagnosis and active treatment. Early endoscopic ligation effectively reduces the risk of rebleeding and mortality. The presence of RCS and advanced variceal grade are significant predictors of poor prognosis.
Onlasyn Ibekenov - Candidate of Medical Sciences, Highest Category Surgeon, Head of the Strategic Block at the National Scientific Center of Surgery Named After A.N. Syzganov, Almaty, Republic of Kazakhstan; E-mail: onlasin72@mail.ru; Tel.: 8 707 740 8039, ORCID: 0000-0001-6605-6435
Abylai Baymakhanov - Candidate of Medical Sciences, Associate Professor, Dean of the Faculty of Postgraduate Education at NJC “Kazakh National Medical University named after S.D. Asfendiyarov, Professor of the Department of Surgical Diseases №1, Almaty, Republic of Kazakhstan; E-mail: baimakhanov.a@kaznmu.kz; Tel.: 8 701 759 4017, ORCID: 0009-0001-0344-1800
Aman Berkinbay - Surgical Resident (2nd year), NJC “Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan; E-mail: aman_98e@mail.ru; Tel.: 8 708 172 1280, ORCID: 0000-0002-3973-7283
Yermek Zheldibaev - Deputy Director for Surgery at the City Emergency Medical Care Hospital, Highest Category Surgeon, Almaty, Republic of Kazakhstan; E-mail: er.med@mail.ru; Tel.: 8 707 527 7792, ORCID: 0009-0004-0216-1307
Makhsat Duisebekov - Head of the Surgery Department, Hepatobiliary Surgeon at the City Emergency Medical Care Hospital, Almaty, Republic of Kazakhstan; E-mail: makhsatduisebekov@yandex.kz; Tel.: 8 701 745 2616, ORCID: 0009-0001-6697-8074
Nurhat Esenbekov - Highest Category Surgeon at the City Emergency Medical Care Hospital, Almaty, Republic of Kazakhstan; E-mail: esenbekovnurhat4@gmail.com; Tel.: 8 747 171 7273, ORCID: 0009-0007-5324-2117
Sabit Iskakov - Endoscopic surgeon, at the City Emergency Medical Care Hospital, Almaty, Republic of Kazakhstan; E-mail: sabit.iskakov@mail.ru, Tel.: 8 707 787 8045, ORCID: 0009-0000-2359-9026
Mazhit Abdykadyrov - Endoscopic surgeon, at the City Emergency Medical Care Hospital, Almaty, Republic of Kazakhstan; E-mail: abdykadyrov.m@gmail.com, Tel.: 8 707 105 0100, ORCID: 0000-0002-9518-5292
Erzhan Tulebaev - Surgical Resident (2nd year), NJC “Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan; E-mail: 1995_erzhan@mail.ru; Tel.: 8 747 222 0213, ORCID: 0009-0007-6053-787X
Dias Myrzash - Surgical Resident (2nd year), NJC “Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan; E-mail: diasmyrzash@gmail.com; Tel.: 8 705 857 4858, ORCID: 0009-0001-7793-2338
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Ibekenov O.T., Baymakhanov A.N.. Berkinbay A.B.. Zheldibaev Y.M., Duisebekov M.K.. Esenbekov N.B., Iskakov S.K., Abdykadyrov M.K., Tulebaev E.S., Myrzash D.D. Analysis of treatment outcomes for bleeding from esophageal and gastric varices // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (3), pp. 143-150. doi 10.34689/SH.2025.27.3.016Related publications:
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