title: Influence of endoscopic variceal ligation on oesophageal motility.
abstract: BACKGROUND
  To determine the change of oesophageal manometry in patients with oesophageal varices before and after oesophageal variceal ligation (EVL).
  
  
  METHODS
  Forty-five patients who had liver cirrhosis and oesophageal varices with high risk of bleeding were managed by EVL. Oesophageal manometry was performed just prior to the ligation and 4-6 weeks after obliteration of varices. Another 45 age- and sex-matched patients without hepatic, oesophageal or systemic disease served as the control group.
  
  
  RESULTS
  At 5 cm above the lower oesophageal sphincter (LES), the amplitude of the contractive wave was significantly lower in patients before EVL (56.9 +/- 31.8 vs 80.1 +/- 30.1, P< 1.05) and returned to the level of control subjects after EVL (76.5 +/- 37.0 vs 80.1 +/- 30.1, P> 0.05). At 10 cm above LES, the amplitude of the contractive wave was significantly lower in patients before and after EVL than the control group (54.3 +/- 29.2 vs 68.1 +/- 29.5, 54.2 +/- 26.0 vs 68.1 +/- 29.5, respectively, P< 0.05). The percentage of tertiary waves was significantly higher in patients before and after EVL than in the control group (31.4 +/- 36.6 vs 5.8 +/- 15.1, 26.9 +/- 32.9 vs 5.8 +/- 15.1, respectively, P< 0.05). However, no significant swallowing disturbance was noted in patients after EVL. There was significantly greater LES length in patients before EVL (4.0 +/- 0.9 vs 3.4 +/- 0.7, P<0.05) but there was no significant difference in the LES length after EVL as compared with the control group. Eighty-six per cent (39/45) of patients developed paraoesophageal varices and 31% (14/45) developed new varices 6 months after variceal obliteration. However, there was no significant difference in manometry at the time of variceal obliteration between patients with variceal recurrence and those without.
  
  
  CONCLUSIONS
  The presence of varices affected oesophageal motility. However, such abnormality had little clinical significance. Endoscopic variceal ligation normalized oesophageal motility and may not induce abnormal oesophageal motility. The manometric change can not be used to predict the recurrence of varices in cirrhotic patients after variceal obliteration.
authors: Department of Medicine, Veterans General Hospital-Kaohsiung, National Yang-Ming University, Taipei, Taiwan.
authors: S M
authors: SM
authors: Chen
authors: G H
authors: GH
authors: Lo
authors: K H
authors: KH
authors: Lai
authors: J S
authors: JS
authors: Jeng
authors: M T
authors: MT
authors: Shen
authors: R L
authors: RL
authors: Huang
authors: C F
authors: CF
authors: Chang
authors: C K
authors: CK
authors: Lin
authors: E M
authors: EM
authors: Wang
mesh_terms: D004932:Esophageal and Gastric Varices / Q000503:physiopathology / Q000601:surgery*; D004943:Esophagogastric Junction / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D016558:Hemostasis, Endoscopic; D006801:Humans; D008026:Ligation; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis