Clinical experience of endoscopic banding ligation for bleeding gastric varices.
OBJECTIVE
Endoscopic variceal ligation is now regarded as the treatment of choice for bleeding esophageal varices. However, it is seldom used to treat bleeding gastric varices. In this a clinical experience of banding ligation to treat bleeding gastric varices is reported.


METHODS
There were 17 male and 5 female patients with active gastric variceal bleeding who received banding ligation. The gastric varices were ligated using pneumoactive ligating devices and an attempt was made to ligate all engorged varices at 1 session. After endoscopic treatment, intravenous omeprazole 40 mg q12 h was given.


RESULTS
An average of 2.8 bands were used (1-5 bands) to ligate the gastric varices at 1 session. All achieved initial hemostasis and there was no immediate complication. However, 4 patients (18.2%) developed early rebleeding and it occurred on the 3rd, 5th, 9th, 14th days after banding ligation respectively. Three of these 4 patients had Grade III gastric varices. Three (13.6%) patients died within 30 days. One died of hepatic failure, one of hepatocellular carcinoma and one of uncontrolled bleeding.


CONCLUSIONS
Variceal ligation is effective for hemostasis of bleeding gastric varices. However, early rebleeding is still a problem and more often encountered with larger gastric varices.
Lee
Tzong-Hsi
TH
Department of Internal Medicine, Far Eastern Memorial Hospital, No.21, Nan-Ya South Road, Sec. 2, Pan-Chiao City, Taipei County, Taiwan 22050. thleekimo@yahoo.com.tw
Shih
Ling-Na
LN
D004932:Esophageal and Gastric Varices / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged