Endoscopic injection sclerotherapy(EIS) is currently the most widely practiced method for treating and eradicating bleeding esophageal varices in repeated sessions, but may be associated with some undesirable local and systemic complications.
Endoscopic
variceal ligation(EVL), which consists of mechanical ligation and thrombosis of varices using elastic "O" -rings, has been recently developed as a non-operative alternative to EIS. But, there are a few reports of longterm follow-up for rebleeding
rate,
recurrence rate, complication and survival rate after EVL. To assess efficacy of EVL for treatment of acute bleeding esophageal varices in liver cirrhosis, we evaluated the initial hemostatic efficacy for actively bleeding varices and the
recurrences of
bleeding, the ability for eradication of varices. The number and duration of treatments needed to eradicate varices, the incidence of complications in 65 cirrhotic patients with acute bleeding esophageal varices. And we also performed longterm
follow-up
for evaluation of rebleeding rate, recurrence rate, complication and survival rate after eradication of varices by repeated sessions. Initial hemostatic efficacy of EVL for actively bleeding varices was 92.3% (12/13). Rebleeding rate before
eradication
of varices was 10.8%(7/65), and mortality rate was 9.23%(6/65). Ability for eradication of varices showed 86.4%(51/59). Mean sessions for eradication of varices were 4.3(3~16), number of bands per person were 35.1(14~16), and mean duration was
8.2(4~16), weeks. Early complications of associated with EVL were rare; chest pain 19.4%, dysphagia 11.9%, fever 1.5%. Forty-three patients had longterm follow-up for mean 10.6(3~19) months. Rebleeding rate was 14.0%, recurrence rateqs was 48.8%,
survival rate after eradication was 81.4%(35/43). Late complication associated wit EVL were not showed. In conclusion, EVL is a safe and effective method for treatment of acute bleeding esophageal varices, and can reduce rebleeding rate and death
rate
form exanguination by periodic repeated sessions after varices eradication in patients with liver cirrhosis.
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