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KMID : 0614619940260050765
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Korean Journal of Gastroenterology
1994 Volume.26 No. 5 p.765 ~ p.770
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The Short-term Effectiveness and Safety of Endoscopic Ligation as Compared with Endoscopic Sclerotherapy for Bleeding Esophageal Varices
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Abstract
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Endoscopic sclerotherapy is an effective method for bleeding esophageal varices, however it is often associated with local and systemic complications which may limit its usefulness. A newly developed endoscopic treatment for bleeding esophageal
varices,
endoscopic variceal ligation, which uses small rubber bands to occulde and eradicate the varices, may cause less damage to the esophagus and have no systemic complication theoretically. We compared the effectiveness and safty of the two
techniques
retrospectively. The patients had proved bleeding from esophagealvarix and showed advanced liver cirrhosis. Nineteen patients were treated with ligation, and 20 patients with sclerotherpy. They were followed for a mean of 4 months. Acitve
bleeding
was
controlled by ligantion in 2 of 3 patients(67%) and by sclerotherapy in 3 of 4 patients(75%). The eradication of varices was achieved by ligation in 6 of 14 patients(43%) and by sclerotherapy in 10 of 15 patients(67%). But the mean number of
treatment
with ligation was lower than that with sclerotherapy(3.4 vs 4.2) and than other ligation treatment group(4-5). There was no significant difference in recurrent hemorrhage between two groups. There were one case of pleural effusion and one cases
of
these
complications occured in ligation treatedpatients. Two cases of treatment induced bleeding were developed in ligation group. Endoscopic variceal ligation has fewer local and/or systemic complications than sclerotherapy. To eradicato varices more
completely and to achieve denudation of lower esophageal mucosa for prevention of recurrent hemorrhage, combination with sclerotherapy would be effective rather than ligation alone. (Korean J Gastroenterol 1994 ; 26 : 765-770)
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