Endoscopic band ligation of esophageal varices

Endoscopic sclerotherapy of esophageal varices rapidly became the standard initial nonsurgical method for control of hemorrhage. Although in widespread use around the world, the technique is associated with a significant complication rate that excludes it as a potential method for primary prophylaxis. The sclerotherapy technique has been difficult to standardize between different endoscopists and centers, with consequent incongruities in trial results and morbidity. The introduction of endoscopic band ligation heralds the possibility of a simple, reproducible method for acute and chronic treatment of varices and the hope that prophylactic eradication, before the first life-threatening hemorrhage, can be achieved safely and effectively.