Detachable endoloop vs. elastic band ligation for bleeding esophageal varices.
BACKGROUND
Variceal bleeding is a serious complication with a mortality rate that ranges from 20% to 50%. Patients who have variceal hemorrhage usually are treated by endoscopic injection sclerotherapy or elastic band ligation to eradicate the varices. Endoloop ligation is a newly developed technique for achieving hemostasis and variceal eradication. This study compared endoloop ligation with elastic band ligation in patients with acute esophageal variceal bleeding.


METHODS
Fifty patients with acute esophageal variceal bleeding were recruited: 25 were treated by elastic band ligation and 25 by endoloop ligation.


RESULTS
Although the number of patients in whom bleeding recurred during a follow-up period of 6 months was smaller in the endoloop group (12%) vs. the band group (28%), this difference was not statistically significant. Furthermore, no statistically significant difference was found between the two groups with respect to the number of patients in whom variceal eradication was achieved, the number of treatment sessions required for variceal eradication, or the frequency of variceal recurrence. The total cost for variceal obliteration by endoloop ligation was 342 dollars per patient, whereas, the total cost of variceal eradication by elastic band ligation was 356 dollars per patient. The endoloop had certain technical advantages over band application: a better field of vision, tighter application, good results with junctional varices, and a lack of strain exerted by the device on the endoscope.


CONCLUSIONS
Endoloop ligation is a promising new technique for management of patients with bleeding esophageal varices.
Naga
Mazen Ibrahim
MI
Department of Internal Medicine and Gastroenterology, Kasr El-Aini Hospitals, Cairo University, Egypt.
Okasha
Hussein Hassan
HH
Foda
Ayman Ragaei
AR
Gomaa
Mohamed Saeed
MS
Fouad
Ayman Mohamed
AM
Masoud
Amgad Gerges
AG
El-din
Hazem Hossam
HH
D000208:Acute Disease; D001803:Blood Transfusion; D004932:Esophageal and Gastric Varices / Q000191:economics / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000191:economics / Q000601:surgery*; D016558:Hemostasis, Endoscopic / Q000191:economics; D006801:Humans; D008026:Ligation / Q000191:economics / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D012008:Recurrence