[Treatment of esophageal varices with banding ligation]

Randomised trials have shown that banding ligation is superior to sclerotherapy, requiring fewer treatment sessions to achieve variceal eradication, and giving lower rebleeding and complication rates.

From November 1997 through December 1999, we have treated 22 patients with bleeding oesophageal varices with endoscopic banding ligation to obliterate the varices and prevent recurrent bleeding.

A total of 72 banding procedures have been performed using rubber bands. The varices have been obliterated in 14 patients requiring a median of 3.5 (range 2-8) procedures, which is in good agreement with other published data. Twelve of these patients have been observed for a median of six (range 1-19) months without signs of recurrent bleeding. One patient had a bleeding four months after the last ligation procedure; the varices were obliterated six weeks before. One patient had a recurrent bleeding between the first and second banding procedure. One patient bled from an oesophageal ulcer caused by a rubber band two weeks after the procedure. Otherwise no serious complications occurred.

On the basis of our own experiences and published studies, we propose that endoscopic banding ligation should be the method of choice for elective treatment of bleeding varices.