Results of rubber band ligation of esophageal varices.
BACKGROUND
The aim of the paper is to analyze the results of endoscopic rubber band ligation of esophageal varices performed between 1 January 1998 and 1 November 2000 at the Department of GI Surgery of 4th Military University Hospital.


METHODS
Cases of 50 patients with massive upper GI variceal bleeding present on admission or with the history of such a bleeding were reviewed. A total of 85 endoscopic procedures of rubber band ligation were performed. In 9 (18%) cases ligation was performed due to massive variceal bleeding, in 1 case the complementary obliteration of stomach fundus varices with Aethoxysclerol was performed. In 10 (20%) cases in grade C of Child-Pough scale of liver failure, 3 endoscopic procedures were performed, in 15 (30%) in grade B--2 procedures, in the remaining 25 (50%) cases, also in grade B--1 procedure was performed. Procedures were conducted with Wilson-Cook Multi-Band Ligator SAEED SixShooter.


RESULTS
In all cases with non-bleeding esophageal varices the overall good result of treatment was achieved, with collapsing of variceal columns. In 8 (88.8%) of 9 cases treated due to variceal bleeding, good hemostasis was achieved and no reintervention was necessary. In 1 case of massive variceal bleeding endoscopic treatment failed and patient eventually died. In 25 (50%) cases the complementary (1 or 2) rubber band ligations were performed. Follow-up period has ranged from 1 to 34 months. No cases of severe complications after the procedure were noted. In early period after the procedure 43 (86%) patients complained of transient, mild retrosternal pain and mild to moderate dysphagia.


CONCLUSIONS
Endoscopic rubber band ligation is a safe and effective treatment for esophageal varices both in cases of variceal bleeding and as elective procedure.
Leszczyszyn
J
J
Department of GI Surgery, 4th Military University Hospital with Polyclinic, ul. Weigla 5, 50-981 Wrocław, Poland.
Łebski
I
I
Massopust
R
R
Skoczylas
M
M
Janus
W
W
D000328:Adult; D004932:Esophageal and Gastric Varices / Q000601:surgery* / Q000628:therapy; D004947:Esophagus / Q000473:pathology; D005260:Female; D006801:Humans; D008026:Ligation / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome