Association of Endoscopic Esophageal Variceal Ligation with Duodenal Ulcer

To determine the frequency of duodenal ulcer (DU), as well as other clinical characteristics occurring after endoscopic variceal ligation (EVL) of the esophagus.

Descriptive study.

The First Affiliated Hospital of Fujian Medical University, Fuzhou, China, from April 2012 to April 2013.

A total of 47 patients with esophageal varices (EVr) who had also undergone EVL and gastroscopic follow-up within 3 months of the procedure was retrospectively analyzed. The status of Helicobacter pylori(Hp) infection, Child-Pugh classification, and the grades of portal hypertensive gastropathy (PHG) were collected. Sixty EVr patients without EVL treatment, but with clinical data available, served as the control group.

The frequency of DU in the EVL group (29.8%, 14/47) was higher than the control group (6.7%, 4/60) (p=0.02). Hp infection rate in EVLgroup was 19.15% (9/47), while in control group was 21.67% (13/60) (p=0.813). Hp positive rate (12.5%, 1/8) in patients exhibited new DUs after EVL was comparable to the patients without DU in the EVL group (12.1%, 4/33) (p=1.00). Patients with DU after EVL received 18.79 ±8.48 of ligating bands, while in those who did not exhibit DUs received 13.85 ±6.47 (z = -2.042, p = 0.041). Logistic regression analysis showed that the occurrence of DU was not associated with age, gender, Child-Pugh classification, or the grade of PHG (p > 0.05).

Esophageal EVL is associated with a higher frequency of developing DU, which is related to a larger number of applied bands but is not correlated with Hp infection status or other variables.