ORIGINAL ARTICLES   

Minerva Gastroenterologica e Dietologica 2011 June;57(2):111-5

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English

Endoscopic banding for esophageal variceal bleeding: technique and patient outcome

Silvano S. ¹, Elia C. ¹, Alessandria C. ¹, Bruno M. ¹, Musso A. ¹, Saracco G. ², Rizzetto M. ², Debernardi Venon W. ✉

¹ Gastro-Hepatology Unit, San Giovanni Battista Hospital, University of Turin, Turin, Italy; ² Unit of Gastroenterology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy.

AIM: Endoscopic variceal ligation (EVL) is recommended for the treatment of esophageal variceal bleeding. The aim of this study was to assess the most cost-effective timing of endoscopic follow-up after variceal eradication.
METHODS: Cirrhotics with esophageal varices treated between January 2008 and January 2009 until reached variceal obliteration were retrospectively analyzed for technical aspects and for outcomes.
RESULTS: Out of 127 patients treated with EVL, 103 were included. Number of sessions to achieve variceal obliteration and number of bands for each session were 2.8±1.3 (range 1-7) and 4.6±1 (range 2-7), respectively. The placement of >5 bands per session was not associated with higher incidence of complications (19.6% vs. 17.8%, P=ns). Esophageal ulcers were observed in 42% of patients when the interbanding interval was <20 days (versus 15% for interval >20 days, P<0.05). Once obliteration was achieved, varices reappeared in 28% of patients; the early appearance of small varices was not associated with bleeding.
CONCLUSION: A longer interbanding interval reduces the incidence of procedural-related complications. After variceal obliteration an early endoscopic control is not useful because it does not influence the approach and does not change the patient outcome.