title: [Endoscopic ligation of esophageal varices: prevention of hemorrhagic recurrences caused by rupture of esophageal varices. Results in 45 patients].
abstract: OBJECTIVE
  The aim of this study was to assess the morbidity and efficacy of endoscopic variceal ligation for the prophylaxis of rebleeding from oesophageal varices.
  
  
  METHODS
  Forty-five patients with cirrhosis (Child's class: A: 18, B: 16, C: 11) and recent (< 48 h) variceal bleeding were included. Eleven of the patients were included after failure of sclerotherapy. All patients were treated by endoscopic ligation until the complete eradication of oesophageal varices. The mean follow-up was 8.7 +/- 6.8 months.
  
  
  RESULTS
  Oesophageal varices were eradicated in 40 patients (89%) after an average of 2 sessions (range: 1-5). In a subset of 11 patients treated after failure of sclerotherapy, 8 (73%) had complete eradication of oesophageal varices. Six of the 45 patients (13%) had recurrence of haemorrhage, due to post-ligation ulcerations in 5 cases and to rupture of oesophageal varices in one case. The rate of complications was 7%. Of the 40 patients whose oesophageal varices were eradicated, 7 (17%) were lost for follow up, and another treatment was performed in 4 (10%): liver transplantation in 2, and transjugular intrahepatic portosystemic shunt in 2. Recurrence of oesophageal varices after eradication was observed in 3 (10%) of the remaining 29 patients after a follow-up of 8.9 +/- 12.9 months. Of these 3 patients, only one (3%) presented with recurrence of haemorrhage due to ruptured oesophageal varices. Three patients (7%) died before eradication of oesophageal varices from causes unrelated to the technique.
  
  
  CONCLUSIONS
  This study confirms that endoscopic ligation is effective for eradication of oesophageal varices, with a low morbidity. This technique appears to be a method of choice in the prophylaxis of rebleeding from oesophageal varices, especially when sclerotherapy is ineffective.
authors: Service d'Hépato-Gastroentérologie, Hôtel-Dieu, Lyon.
authors: T
authors: T
authors: Bizollon
authors: J L
authors: JL
authors: Gaudin
authors: P
authors: P
authors: Jacob
authors: B
authors: B
authors: Bouvet
authors: M
authors: M
authors: Evreux
authors: J C
authors: JC
authors: Souquet
authors: C
authors: C
authors: Trépo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D008026:Ligation; D008103:Liver Cirrhosis / Q000150:complications* / Q000821:virology; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D012422:Rupture, Spontaneous / Q000150:complications
vernacular_title: Ligature endoscopique des varices oesophagiennes: prévention des récidives hémorragiques par rupture de varices oesophagiennes. Résultats chez 45 malades.