Evaluation of endoscopic variceal ligation in prophylactic therapy for bleeding of oesophageal varices: a prospective, controlled trial compared with endoscopic injection sclerotherapy.
BACKGROUND
To evaluate the efficacy of endoscopic variceal ligation (EVL) in prophylactic therapy for oesophageal varices, we performed a randomized prospective trial to compare the recurrence of oesophageal varices treated by EVL with those treated by endoscopic injection sclerotherapy.


METHODS
Fifty patients with liver cirrhosis were divided into two groups at random, after informed consents were obtained, to receive prophylactic therapy for bleeding of oesophageal varices. Group 1 patients underwent sessions of sclerotherapy with 5% ethanolamine oleate used as the sclerosant. Group 2 patients underwent EVL followed by one or two sessions of sclerotherapy.


RESULTS
During the 18 month follow-up period, both the recurrence rate in group 2 (56%) and the incidence of bleeding (20%) were significantly higher compared with group 1 (recurrence rate 16%, bleeding 0%).


CONCLUSIONS
This result indicates that EVL is not effective for prophylactic therapy for oesophageal varices in liver cirrhosis.
Gotoh
Y
Y
Department of Internal Medicine, Saga Medical School, Japan.
Iwakiri
R
R
Sakata
Y
Y
Koyama
T
T
Noda
T
T
Matsunaga
C
C
Ogata
S I
SI
Ishibashi
S
S
Sakata
H
H
Tsunada
S
S
Fujimoto
K
K
D004932:Esophageal and Gastric Varices / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D016558:Hemostasis, Endoscopic; D006801:Humans; D008026:Ligation; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D009829:Oleic Acids / Q000627:therapeutic use*; D011446:Prospective Studies; D012008:Recurrence; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D013997:Time Factors
D009829:Oleic Acids; D012597:Sclerosing Solutions; C033343:ethanolamine oleate