Elastic band ligation for bleeding esophagogastric varices.

Experimental studies have shown ligation results in replacement of submucosal structures, including varices, with scar tissue resulting in eradication of varices. Elastic band ligation is equal in efficacy to sclerotherapy for control of active bleeding from esophageal varices. Ligation appears superior to sclerotherapy for long-term prevention of recurrent variceal bleeding, requires fewer treatment sessions to eradicate varices, is associated with fewer bleeding and non-bleeding complications of treatment, and results in improved survival. Results from the synchronous combination of elastic band ligation with sclerotherapy do not appear to be superior to those obtainable with those from endoscopic ligation used alone.