Evaluation of endoscopic variceal ligation in prophylactic therapy for bleeding of oesophageal varices: A prospective, controlled trial compared with endoscopic injection sclerotherapy

• Published in: Journal of gastroenterology and hepatology 1999-03, Vol.14 (3), p.241-244
• Main Authors: Gotoh, Yudai, Iwakiri, Ryuichi, Sakata, Yasushi, Koyama, Takanori, Noda, Takahiro, Matsunaga, Chika, Ogata, Shin-Ichi, Ishibashi, Sadatoshi, Sakata, Hiroyuki, Tsunada, Seiji, Fujimoto, Kazuma
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; endoscopic therapy; Esophageal and Gastric Varices - epidemiology; Esophageal and Gastric Varices - therapy; Esophagus; ethanolamine oleate; Female; Follow-Up Studies; Gastrointestinal Hemorrhage - epidemiology; Gastrointestinal Hemorrhage - prevention & control; Gastrointestinal Hemorrhage - therapy; Hemostasis, Endoscopic; Humans; Ligation; liver cirrhosis; Liver Cirrhosis - complications; Male; Medical sciences; Middle Aged; Oleic Acids - therapeutic use; Prospective Studies; Recurrence; recurrence of oesophageal varices; Sclerosing Solutions - therapeutic use; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Time Factors
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1046/j.1440-1746.1999.01841.x

Background: To evaluate the efficacy of endoscopic variceal ligation (EVL) in prophylactic therapy for oesophageal varices, we performed a randomized prospective trial to compare the recurrence of oesophageal varices treated by EVL with those treated by endoscopic injection sclerotherapy. Methods: Fifty patients with liver cirrhosis were divided into two groups at random, after informed consents were obtained, to receive prophylactic therapy for bleeding of oesophageal varices. Group 1 patients underwent sessions of sclerotherapy with 5% ethanolamine oleate used as the sclerosant. Group 2 patients underwent EVL followed by one or two sessions of sclerotherapy. Results: During the 18 month follow‐up period, both the recurrence rate in group 2 (56%) and the incidence of bleeding (20%) were significantly higher compared with group 1 (recurrence rate 16%, bleeding 0%). Conclusions: This result indicates that EVL is not effective for prophylactic therapy for oesophageal varices in liver cirrhosis.