Butt Nazish, Abbasi Amanullah, Ali Khan M, Butt Sehrish, Ahmad Syed Masroor
Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, PAK.
Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
Cureus. 2019 Jun 25;11(6):e4993. doi: 10.7759/cureus.4993.
Introduction Esophageal variceal band ligation (EVBL) is the best form of treatment for variceal bleeding. The frequency of EVBL for the eradication of esophageal varices has no consensus. We evaluated the number and interval of EVBL sessions required for the obliteration of esophageal varices. Methods Esophagogastric varices were treated endoscopically with band ligation on initial presentation and then every after three weeks till the obliteration of the varices. Endoscopic band ligation consists of placing rubber elastic bands on large varices. Frequencies were calculated for qualitative variables and mean ± standard deviations for continuous variables. Results A total of 107 cases with esophagogastric varices were enrolled. Out of them, seven patients with small esophageal varices and large fundal varices were excluded. The remaining 100 with large esophageal varices had EVBL performed. The second session of EVBL was done in 46 patients with large esophageal varices. The third session of EVBL for the obliteration of esophageal varices required in 20 patients with large esophageal varices and the fourth session was required in only two patients. The total sessions required for the complete obliteration for esophageal varices were 2±1. Only one patient developed post-EVBL bleeding one week after band ligation. Conclusion Esophageal variceal ligation was a safe and well-tolerated procedure performed at three-week intervals in patients with large esophageal varices. On average, two to three sessions of EVBL are required for the complete obliteration of esophageal varices.
引言 食管静脉曲张套扎术（EVBL）是治疗静脉曲张出血的最佳方法。对于根除食管静脉曲张所需的EVBL频率尚无共识。我们评估了消除食管静脉曲张所需的EVBL疗程数量和间隔时间。方法 对初次就诊时的食管胃静脉曲张进行内镜下套扎治疗，之后每三周进行一次，直至静脉曲张消除。内镜下套扎术是在大的静脉曲张上放置橡胶弹力带。对定性变量计算频率，对连续变量计算均值±标准差。结果 共纳入107例食管胃静脉曲张患者。其中，7例小食管静脉曲张和大胃底静脉曲张患者被排除。其余100例大食管静脉曲张患者接受了EVBL治疗。46例大食管静脉曲张患者进行了第二次EVBL治疗。20例大食管静脉曲张患者需要进行第三次EVBL以消除食管静脉曲张，仅2例患者需要进行第四次治疗。完全消除食管静脉曲张所需的总疗程为2±1次。仅1例患者在套扎术后一周出现EVBL后出血。结论 食管静脉曲张套扎术是一种安全且耐受性良好的手术，对大食管静脉曲张患者每三周进行一次。平均而言，完全消除食管静脉曲张需要两到三次EVBL治疗。
