Bleeding from varicose veins of the esophagus: endoscopic diagnosis, prevention and treatment
Varicose veins of the esophagus are detected in 30-40 % of patients with compensated cirrhosis of the liver and in 60% with decompensated cirrhosis, at the time of its diagnosis. The frequency of bleeding from varicose veins of the esophagus is 4% per year. The risk increases to 15% in patients with medium to large veins. The risk of recurrent bleeding is very high and depends on the severity of cirrhosis: in the first year, relapse is observed in 28% of patients with Grade A (according to Child-Pugh), in 48% - with B, in 68% - with C. Despite the achievements of recent decades, bleeding from esophageal and gastric HPV is accompanied by a mortality rate of 10-20% within 6 weeks.
Endoscopic therapy is the primary treatment for patients with esophageal varicose veins. Currently, it is recommended to use endoscopic therapy for both primary and secondary prevention, as well as in conditions of acute bleeding in conjunction with drug therapy.
The course includes three blocks-the first is devoted to the possibilities of Endoscopy in the diagnosis of varicose veins of the esophagus and the identification of criteria for the risk of bleeding. The second and third blocks are devoted to endoscopic methods of prevention and emergency stopping of bleeding from varicose veins of the esophagus.
Form of training: full-time.
Feature the course being studied is an internship at the workplace in the form of assistance in performing diagnostic and operational manipulations, analysis of clinical cases with assessment of Clinical, Laboratory, instrumental data, with the formulation of the diagnosis; development of an algorithm for managing patients.
Students who have completed training and successfully passed the final certification in the form of a test and interview receive certificate of professional development.
Audience category: specialists with higher education (doctors) in the field of training "endoscopy", "surgery".
Duration of training: 18 academic hours. The mode of classes is in accordance with the calendar academic schedule (6 academic hours per day).
Document issued after completion of training: certificate of professional development.
Educational program of additional professional education - advanced training program "bleeding from varicose veins of the esophagus: endoscopic diagnosis, prevention and treatment" (hereinafter – advanced training program) developed in the state budgetary healthcare institution of Moscow "Moscow clinical scientific and practical center named after A. S. Loginov of the Department of health of Moscow" (hereinafter-GBUZ MCSC named after A. S. Loginov dzm, Center) includes the content of the working program of the discipline (module), curriculum, attestations and final certification.
Purpose of the program - improving the knowledge of specialists on the identification, differential diagnosis and endoscopic treatment of patients with varicose veins of the esophagus.
The educational program includes lectures, practical training and analysis of interesting cases from practice.
Tasks solved in the course of training:
1. to study the possibilities of Endoscopy in the diagnosis of varicose veins of the esophagus.
2. mastering the algorithm of actions by students in case of acute varicose bleeding.
3. mastering the technique of endoscopic ligation of varicose veins of the esophagus by students.
4. mastering the methods of endoscopic prevention of varicose bleeding by students.
As a result of the course, the student should acquire or update general and special knowledge and skills in the diagnosis and surgical treatment of bleeding from varicose veins of the esophagus.
Curators of the professional development cycle:
- Kirill V. Shishin, MD, Head of the Department of endoscopy GBUZ MCSC named after A. S. Loginov dzm;
- Nedoluzhko Ivan Yuryevich, Ph. D., Head of the Department of operative endoscopy of GBUZ MCSC named after A. S. Loginov dzm;
- Shumkina Lada Vyacheslav, candidate of medical sciences, research associate of the Department of operative endoscopy of GBUZ MCSC named after A. S. Loginov dzm.
Professional development program