Endoscopic Variceal Band Ligation: A Safe Way to Treat Oesophageal Varices
Clinical Medicine Research
Volume 5, Issue 3, May 2016, Pages: 35-38
Received: Apr. 3, 2016; Accepted: Apr. 20, 2016; Published: May 3, 2016
Views 3438      Downloads 94
Ale Alexander Femi, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
Achinge Godwin Ior, Department of Medicine, Benue State University Teaching Hospital, Makurdi, Nigeria
Peter Solomon Danjuma, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
Shitta Andrew Haruna, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
Misauno Michael Ayedima, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
Article Tools
Follow on us
Bleeding from oesophageal varices is the most dreaded complication of chronic liver disease and is associated with high mortality. Endoscopic variceal ligation is one of the more recent effective treatment modalities. This study was aimed at evaluating our experience with endoscopic variceal ligation with a view to stressing the safety associated with the procedure. A prospective study of consecutive patients presenting to the Jos University Teaching Hospital and FOMAS hospital endoscopic units was conducted over a 6 year period. A total of 199 sessions of endoscopic sessions were carried out on 83 patients with different grades of varices. There were 68 males and 15 females (M:F = 4.5:1). The mean age of the study population was 48 +/- 7.4 years with age range of 17 to 63 years. The number of sessions of banding required for variceal obliteration in this study varied from 43 (51.8%) who had 3 sessions of banding, 30 (36.1%) who had 2 sessions and 10 (12.0%) that had a single session of variceal band ligation. All patients were placed on Propanolol tablets. There were no recorded episodes of procedure related bleeding, significant re-bleeding, post-procedure retrosternal pain, stricture or ulceration in this study, attesting to the safety of endoscopic variceal ligation.
Oesophageal Varices, Varices, Endoscopic Variceal Ligation, Variceal
To cite this article
Ale Alexander Femi, Achinge Godwin Ior, Peter Solomon Danjuma, Shitta Andrew Haruna, Misauno Michael Ayedima, Endoscopic Variceal Band Ligation: A Safe Way to Treat Oesophageal Varices, Clinical Medicine Research. Vol. 5, No. 3, 2016, pp. 35-38. doi: 10.11648/j.cmr.20160503.14
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
El Sayed G, Tarff S, O'Beirne J, Wright G. Endoscopy management algorithms: role of cyanoacrylate glue injection and self-expanding metal stents in acute variceal haemorrhage. Frontline Gastroenterol. 2015 Jul; 6(3): 208-16.
Archampong TN, Tachi K, Agyei AA, Nkrumah KN. The Significance of Variceal Haemorrhage in Ghana: A Retrospective Review. Ghana Med J. 2015 Sep; 49(3): 142-6.
Schettini AV, Pinheiro RS, Pescatore P, Lerut J. Modified Sugiura Operation for Idiopathic Portal Hypertension with Bleeding Oesophageal Varices. A Case Report. ActaChir Belg. 2015 May-Jun; 115(3): 237-40.
Ruiz-Blard E, Baiges A, Turon F, Hernandez-Gea V, Garcia-Pagan JC. [Early Transjugular intrahepatic portosystemic shunt: When, how and in whom?]. Gastroenterol Hepatol. 2015 Nov 20.
Rios Castellanos E, Seron P, Gisbert JP, Bonfill Cosp X. Endoscopic injection of cyanoacrylate glue versus other endoscopic procedures for acute bleeding gastric varices in people with portal hypertension. Cochrane Database Syst Rev. 2015; 5: CD010180.
Drazna E. [Pharmacotherapy of portal hypertension]. VnitrLek. 1995 Mar; 41(3): 185-8.
Avgerinos A, Armonis A. Balloon tamponade technique and efficacy in variceal haemorrhage. Scand J Gastroenterol Suppl. 1994; 207: 11-6.
Seet E, Beevee S, Cheng A, Lim E. The Sengstaken-Blakemore tube: uses and abuses. Singapore Med J. 2008 Aug; 49(8): e195-7.
Sutedja DS, Kang JY. Endoscopic banding ligation treatment for bleeding oesophageal varices. Ann Acad Med Singapore. 1996 Sep; 25(5): 708-11.
Serpa TH. [Endoscopic ligation of oesophageal varices]. Rev Gastroenterol Peru. 1996 Sep-Dec; 16(3): 244-8.
Tait IS, Krige JE, Terblanche J. Endoscopic band ligation of oesophageal varices. Br J Surg. 1999 Apr; 86(4): 437-46.
Bhuiyan MM, Rahman MM, Kibria MG, Hasan M. Comparative study of endoscopic band ligation and sclerotherapy for treatment of oesophageal varices in cirrhotic patients. Bangladesh Med Res Counc Bull. 2007 Apr; 33(1): 31-9.
Viazis N, Armonis A, Vlachogiannakos J, Rekoumis G, Stefanidis G, Papadimitriou N, et al. Effects of endoscopic variceal treatment on oesophageal function: a prospective, randomized study. Eur J Gastroenterol Hepatol. 2002 Mar; 14(3): 263-9.
Laine L, el-Newihi HM, Migikovsky B, Sloane R, Garcia F. Endoscopy ligation compared with Sclerotherapy for treatment of bleeding esophageal varices. Ann Intern Med. 1993; 119(1): 1-7.
Slosberg EA, Keefe EB. Sclerotherapy versus banding in the treatment of variceal bleeding. Clin Liver Dis. 1997; 1(1): 77-84.
Dai C, Liu WX, Jiang M, Sun MJ. Endoscopic variceal ligation compared with endoscopic injection Sclerotherapy for treatment of esophageal variceal hemorrhage: a meta-analysis. World J Gastroenterol. 2015; 21(8): 2534-41.
Svoboda P, Kantorova I, Ochmann J, Kozumplik L, Marsova J. A prospective randomized controlled trial of Sclerotherapy vs ligation in the prophylactic treatment of high-risk esophageal varices. Surg Endosc. 1999; 13(6): 580-4.
Masci E, Stigliano R, Mariani A, Bertoni G, Baroncini D, Cennamo V et al. Prospective multicentre randomized trial comparing banding ligation with Sclerotherapy of oesophageal varices .Hepatogastroenterology. 1999; 46(27): 1769-73.
Sarin SK, Govil A, Jain AK, Guptan RC, Issar SK, Jain M, Murthy NS. Prospective randomized trial of endoscopic sclerotherapy versus variceal band ligation for esophageal varices: influence on gastropathy, gastric varices and variceal recurrence. J Hepatol. 1997; 26(4): 826-32.
Udeze AO, Okonko IO, Donbraye E, Sule WF, Fadeyi A, Uche IN. Seroprevalence of Hepatitis C virus Antibodies amongst blood donors in Ibadan, Southwestern, Nigeria. World Applied Sciences Journal. 2009; 7(8): 1023-1028.
Halim NKD, Offor E, Ajayi OI. Epidemiological study of the seroprevalence of Hepatitis-B surface antigen(HBsAg) and HIV-1 in blood donors. Nig J ClinPract 1992; 2: 42-5.
Baba MM, Gashau W, Hassan AW. Detection of Hepatitis-B surface antigenaemia in patients mirth and without the manifestation of AIDS in Maiduguri, Nigeria. Nig Postgrad Med J 1998; 5: 125-8.
Schepke M, Kleber G, Nurnberg D, Willert J, Koch L, Veltzke-Schlieker W et al. Ligation versus propanolol for the primary prophylaxis of variceal bleeding in cirrhosis. Hepatology 2004; 40: 65-72.
Lay CS, Tsai YT, Lee FY, Lai YL, Yu CJ, Chen CB, Peng CY. Endoscopic variceal ligation versus propanololin prophylaxis of first variceal bleeding in patients with cirrhosis. J Gastroenterol Hepatol. 2006; 21: 413-419.
Perez-Ayuso RM, Valderrama S, Espinoza M, Rollan A, Sanchez R, Otarola F et al. Endoscopic band ligation versus propanolol for the primary prophylaxis of variceal bleeding in cirrhotic patients with high risk esophageal varices. Ann Hepatol. 2010; 9(1): 15-22.
Abraldes JG, Tarantino I, Turnes J, Garcia-Pagan JC, Rodes J, Bosch J. Hemodynamic response to pharmacological treatment of portal hypertension and long term prognosis of cirrhosis. Hepatology. 2003: 37(4): 902-8.
Merkel C, Bolognesi M, Sacerdoti D, Bombonato G, Bellini B, Bighin R, Gatta A. The hemodynamic response to medical treatment of portal hypertension as a predictor of clinical effectiveness in the primary prophylaxis of variceal bleeding in cirrhosis. Hepatology. 2000; 32(5): 930-4.
Grozmann RJ, Bosch J, Grace ND, Conn HO, Garcia-Tsao G, Navasa M et al. Hemodynamic events in a prospective randomized trial of propanolol versus placebo in the prevention of a first variceal hemorrhage. Gastroenterology 1990; 99: 1401-1407.
Tammy Tursi. Use of Beta-blocker therapy to prevent primary bleeding of oesophageal varices. J Am Acad Nurse Pract. 2010; 22(12): 640-647.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186