Endoscopic ligation of esophageal varices

Article Abstract:

Esophageal varices are enlarged and swollen veins at the lower end of the esophagus that may hemorrhage suddenly, which has a high mortality. Endoscopic treatment of these varices may be an alternative to treatment by sclerotherapy, which is injection of a sclerosing, or hardening, agent directly into the esophageal varices to stop the bleeding. Significant complications occur in up to 20 percent of sclerotherapy cases. A report is presented of 100 patients with bleeding esophageal varices who were treated with a new endoscopic ligating technique. This technique places small elastic 'O' rings around the varices, which strangles them. The average age of the patients was 52 years old, and there were 67 men in the study. There were 21 patients who had active bleeding at the time of endoscopic ligation; bleeding was controlled in 18 of these patients (86 percent). Patients were followed for an average of 15 months. Twenty-six patients died during the study, 12 of whom died during the initial hospitalization. Of the 88 patients who survived initially, 41 patients had 72 episodes of rebleeding. All but 5 cases of rebleeding occurred before the varices had been eradicated. Of the 88 patients who survived the initial hospitalization, there were 60 patients who had their ulcers eradicated. Each patient required an average of five treatments. Three non-bleeding complications occurred in the 462 treatment sessions. Endoscopic esophageal ligation may have some advantages over sclerotherapy. Endoscopic ligation requires only visualization of the varices, followed by ligation; sclerotherapy requires precise placement of the injection of the sclerant into the varices. Additionally, use of an overtube during ligation appears to provide some protection from aspiration during the procedure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Innovations, Surgery, Esophageal varices, Endoscopic surgery

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Management of esophageal perforations: the value of aggressive surgical treatment

Article Abstract:

United States, Care and treatment, Methods, Patient outcomes, Esophagus, Esophageal surgery, Esophageal diseases

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