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[Elastic band ligation in secondary prevention of esophageal varices hemorrhage]
S Hrusovský1, H Narwan, E Gocár
11st Dpt of Internal Medicine, Derer University Hospital, Bratislava, Slovakia.
Background:
Sclerotization of esophageal varices may result in serious esophageal destruction. Elastic band ligation of esophageal varices is recently used in similar indications.
Aim:
The aim of the study was to evaluate in a pilot study the efficacy and safety of elastic band ligation for secondary prevention of bleeding from esophageal varices in patients who experienced life-threatening and were not yet treated with elastic band ligation.
Patients And Methods:
Saeed's method of elastic band ligation was used in 10 patients (5 men and 5 women) aged from 16-60, who had already experienced life-threatening esophageal varices hemorrhage. One patient awaiting liver transplantation underwent preventive ligation.
Results:
Esophageal varices were eradicated in 5 patients, minimum range residual varices remained in 4 patients after ligation. Haemorrhage recurrence was observed in 4 patients and was successfully treated by single urgent sclerotization. Two patients developed neo-varices. The ligation program was stopped in one female patient with mitral stenosis and tricuspidal insufficiency because of stenocardias occurring during ligation. In one session, 4.5 elastic bands in average were applied. The treatment of one patient required 4 sessions during 2.5 months in average.
Conclusion:
Elasic band ligation is an effective and safe method for the treatment of esophageal varices. Short term results are promising. (Tab. 1, Fig. 1, Ref. 18.)