Endoscopic variceal ligation: an alternative to sclerotherapy

Stiegmann, Gregory V.; Goff, John S.; Sun, John; Davis, Deborah; Bozdech, John M.

doi:10.1016/s0016-5107(89)72850-9

Cited by 83 publications

(35 citation statements)

References 7 publications

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“…The first reports of EVL appeared in 1988 by Stiegmann et al [68] . While ES used chemical action to obliterate varices, EVL causes a mechanical strangulation with rubber bands that induces thrombosis with ischemic necrosis of the mucosa.…”

Section: Endoscopic Variceal Ligation (Evl)mentioning

confidence: 99%

Endoscopic Management of Variceal Haemorrhage

Dell’Era

Iannuzzi

Franchis

2015

Journal of Gastroenterology and Hepatology Research

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One of the most important complications of portal hypertension, in the setting of liver cirrhosis or of non-cirrhotic portal hypertension, is upper gastrointestinal bleeding from ruptured gastroesophageal varices and portal hypertensive gastropathy. The management of the acute variceal bleeding is a multidisciplinary process that includes the initial assessment of the patient, effective resuscitation, timely diagnosis, control of bleeding and prevention of early rebleeding and complications such as infection, hepatorenal syndrome, or hepatic encephalopathy. Antibiotic prophylaxis, conservative targets for blood transfusions and combination therapy with vasoactive drugs and endoscopic treatments are the first-line measures in the management of acute variceal bleeding; transjugular intrahepatic portosystemic shunts should be proposed early to high-risk patients or as a rescue therapy for those who fail first-line treatment.

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Section: Endoscopic Variceal Ligation (Evl)mentioning

confidence: 99%

Endoscopic Management of Variceal Haemorrhage

Dell’Era

Iannuzzi

Franchis

2015

Journal of Gastroenterology and Hepatology Research

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“…By eliminating sclerosant solutions, endoscopic banding ligation has reduced the complication rate associated with EV endoscopic treatment [10][11][12]. Several prospective studies have proven the efficacy of such procedure in the treatment of EV bleeding [13,14].…”

Section: Introductionmentioning

confidence: 99%

Band Ligation or Sclerotherapy as EndoscopicTreatment for Oesophageal Varices in SchistosomoticPatients: Results of a Randomized Study

et al. 1998

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Endoscopic sclerotherapy and banding ligation are the two preferred methods to treat oesophageal variceal bleeding. There are many reports dealing with such treatment in cirrhotic patients but we do not know how good they are to treat varices secondary to other forms of portal hypertension. Schistosomiais mansoni is the main cause of portal hypertension and oesophageal varices in Brazil. We performed a prospective randomised study to compare: 1) the efficacy of both treatments in eradicating oesophageal varices, and 2) complications secondary to both treatments. Forty patients were divided in two Groups. Both sclerotherapy and banding ligation were performed until variceal eradication. There were no severe complications. Variceal eradication was faster obtained with banding ligation than sclerotherapy although there was no statistical difference (mean number of sessions 3.05 vs 3.72, p=0.053). Benign complications were equally frequent in both Groups, although additional sedation was more common in the sclerotherapy Group. We concluded that both treatments are equally effective in the eradication of oesophageal varices, although banding ligation is better tolerated by the patient and probably faster.

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“…Stiengmann had the idea to transfer band elastic ligature used for hemorrhoidal ligature, to the treatment of esophageal varices. 40 With the help of Dr Goff, an engineer of University of Colorado, he developed a device to band esophageal varices. After extensive experiments in animals, he organized a multicenter randomized trial which showed the superiority of band ligature in comparison to sclerotherapy.…”

Section: Endoscopic Therapy For Recurrent Variceal Bleedingmentioning

confidence: 99%