Long-term follow-up of patients with liver cirrhosis after endoscopic esophageal varices ligation therapy: comparison with ethanol injection therapy.
OBJECTIVE
Esophageal variceal hemorrhage is the most dreaded complication of liver disease. Prevention or emergency therapy of bleeding is important.


METHODS
A group of 217 patients underwent endoscopic esophageal variceal therapy including endoscopic ethanol injection, endoscopic esophageal variceal ligation, or a combination of the two.


RESULTS
Esophageal varices were eradicated by endoscopic esophageal variceal ligation with the least sessions required, and associated complications with endoscopic esophageal variceal ligation therapy were lower than with the other two approaches. However, the cumulative recurrence-free period of esophageal varices was significantly higher after endoscopic ethanol injection than after endoscopic esophageal variceal ligation and in some cases F3 varices were observed post-endoscopic esophageal variceal ligation hemorrhage. A combined endoscopic esophageal variceal ligation and endoscopic ethanol injection therapy had no advantage with respect to cumulative recurrence-free rate, session number, or complication frequency, relative to either therapy alone.


CONCLUSIONS
While the combined observations indicate that endoscopic esophageal variceal ligation is safe and simple, we should consider additional therapy to achieve complete mucosal fibrosis of the esophagus after endoscopic esophageal variceal ligation.
Okano
Hiroshi
H
First Department of Internal Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Shiraki
Katsuya
K
Inoue
Hidekazu
H
Kawakita
Tomoyuki
T
Deguchi
Masatoshi
M
Sugimoto
Kazushi
K
Sakai
Takahisa
T
Ohmori
Shigeru
S
Murata
Kazumoto
K
Nakano
Takeshi
T
D000328:Adult; D000368:Aged; D002423:Cause of Death; D003131:Combined Modality Therapy; D004932:Esophageal and Gastric Varices / Q000401:mortality / Q000628:therapy*; D004945:Esophagoscopy; D004947:Esophagus / Q000098:blood supply*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008026:Ligation; D008103:Liver Cirrhosis / Q000150:complications / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009829:Oleic Acids / Q000008:administration & dosage; D010043:Outcome and Process Assessment, Health Care; D011379:Prognosis; D015911:Sclerotherapy; D055502:Secondary Prevention; D015996:Survival Rate
D009829:Oleic Acids; C033343:ethanolamine oleate