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Endoscopic variceal ligation in children
S Nijhawan1, T Patni, U Sharma
1Department of Gastroenterology, SMS Medical College, Jaipur, India.
Journal of Pediatric Surgery
|October 1, 1995
Summary
Endoscopic variceal ligation effectively obliterates esophageal varices in children with extrahepatic portal vein obstruction. This safe procedure achieved high obliteration rates with minimal complications, offering a promising early treatment option.
Area of Science:
- Pediatric Gastroenterology
- Interventional Endoscopy
Background:
- Extrahepatic portal vein obstruction (EHPVO) can lead to esophageal varices in children.
- Esophageal varices pose a risk of life-threatening hemorrhage.
Purpose of the Study:
- To evaluate the efficacy and safety of endoscopic variceal ligation (EVL) for variceal obliteration in pediatric EHPVO patients.
- To assess the recurrence rate and complications associated with EVL in this population.
Main Methods:
- EVL was performed on 15 pediatric patients (mean age 8.13 years) with grade III varices due to EHPVO.
- The procedure involved mechanical obliteration using endoscopic bands over multiple sessions.
Main Results:
- Successful variceal obliteration was achieved in 14 out of 15 patients (93.33%) after a mean of 1.86 sessions.
- A mean of 4.33 bands were used per patient, with 1.38 bands per variceal column.
- No blood transfusions were required, and only one patient experienced postligation hemorrhage; no other complications were noted.
- One case of variceal recurrence was observed during a mean 9-month follow-up.
Conclusions:
- Endoscopic variceal ligation is a safe and effective method for early variceal obliteration in children with EHPVO.
- EVL demonstrates a low complication rate and minimal recurrence, making it a suitable therapeutic option.