[Prevention of hemorrhagic recurrences caused by rupture of esophageal varices, with endoscopic ligation. Prospective study of 50 patients].
OBJECTIVE
Endoscopic sclerotherapy is effective to prevent bleeding of oesophageal varices but is associated with frequent adverse effects. Endoscopic ligation represents a new endoscopic alternative treatment to sclerotherapy. The purpose of this study was to assess efficacy and safety of endoscopic variceal ligation in 50 consecutive patients with cirrhosis who had recently bled from oesophageal varices.


METHODS
Patients were followed from 6 to 1140 days (median 310 days). Nine patients were bleeding actively when ligation was performed.


RESULTS
Eleven patients (22%) had 13 recurrent bleedings requiring blood transfusion during follow-up. Six recurrences occurred during the first month (3 from bleeding varices, 3 treatment-induced); seven recurrences occurred latter (6 from bleeding varices, 1 treatment-induced). Varices were eradicated in 33 patients (66% of all patients, 82% of patients who survived more than 30 days). Variceal eradication was achieved in 2-9 endoscopic ligation sessions (median 3). Eighteen patients died during the study; one died from bleeding. No patient developed major complications; five patients only complained of mild dysphagia for 24 to 48 hours.


CONCLUSIONS
Endoscopic ligation is a safe and effective method to prevent recurrent bleeding from oesophageal varices.
Aubert
A
A
Departement d'Endoscopie digestive, CMC Foch, Suresnes.
Meduri
B
B
Roulot
D
D
Blondon
H
H
Coste
T
T
Fritsch
J
J
D004724:Endoscopy / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008026:Ligation / Q000379:methods; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012422:Rupture, Spontaneous
Prévention par ligatures élastiques des récidives hémorragiques par rupture de varices oesophagiennes. Etude prospective de 50 patients.