Endoscopic band ligation and esophageal stents for acute variceal bleeding

Patients with portal hypertension and esophageal varices are at risk of bleeding due to a progressive increase in portal pressure that may rupture the variceal wall. Appropriate treatment with initial general measures, such as resuscitation, a restrictive transfusion policy, antibiotic prophylaxis, pharmacologic therapy with vasoconstrictors, and endoscopic therapy with endoscopic band ligation are mandatory. However, 10% to 15% of patients fail initial endoscopic therapy and thus rescue therapies are needed. This article reviews the current endoscopic strategies with band ligation and esophageal stents for patients with acute variceal bleeding.