Endoscopic variceal ligation(EVL) is effective in both emergent and elective treatment of esophageal varices and can be a safe alternative to sclerotherapy. However, as yet no transparent ligating device is widely available, the endoscopic view
through
the present commercial ligating device is so narrow that it is often difficult to both approach the target and accurately define and position the bleeding site. To assess the benifit of transparent EVL device, total 143 patients. 632 sessions,
underwent
EVL treatment. In 545 sessions the non-transparent, conventional-type ligating devices (Stigmann-Goff ligating devices)were used, whereas in 87 sessions the transparent ligating devices used. 35 patients underwent EVL under active bleeding
conditions;
in 29 patients a conventional ligation devices, whereas in 6 patients a transparent ligating devices were used. The remaining 108 patients were either electively treated by EVL. The visual fields decreased to 20-30% with the conventional devices,
but no
change of visual fields were noted with the transparent devices. In electively treated cases by EVL, the times need to ligate one band were not significaltly different in the conventional devices(average, 18.5 sec) compared with that in the
transparent
devices (averge, 16.7 sec), but in active bleeding conditions it took a significantly longer times in the conventional devices (mean, 30.7 sec) compared with that in the transparent devices (average, 19.4 sec). The hemostatic success rates in
active
bleeding conditions were 89.7%(26/29) using the conventional devices, 100%(6/6) using the transparent devices. In conclusion this newly developed transparent ligating device provides an improved visual field and shortens ligating time, especially
in
active bleeding conditions. Therefore EVL using transparent device is more effective method in treatment of esophageal varices, especially active bleeding conditions.
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