title: [Comparison of band ligation with sclerotherapy for the treatment of bleeding esophageal varices].
abstract: BACKGROUND
  Endoscopic band ligation is the treatment of choice for bleeding esophageal varices. However it is not clear if this procedure is associated with less early and late mortality than sclerotherapy.
  
  
  OBJECTIVE
  To assess rates of re-bleeding and mortality in cohorts of patients with bleeding esophageal varices treated with endoscopic injection or band ligation.
  
  
  METHODS
  Analysis of medical records and endoscopy reports of two cohorts of patients with bleeding esophageal varices, treated between 1990 and 2010. Of these, 54 patients were treated with sclerotherapy and 90 patients with band ligation. A third cohort of 116 patients that did not require endoscopic treatment, was included. The mean analyzed follow up period was 2.5 years (range 1-16). Collection of data was retrospective for patients treated with sclerotherapy and prospective for patients treated with band ligation. Rates of re-bleeding and medium term mortality were assessed.
  
  
  RESULTS
  During the month ensuing the first endoscopic treatment, re-bleeding was recorded in 39 and 72% of patients treated with band ligation and sclerotherapy, respectively (p < 0.01). The relative risk of bleeding after band ligation was 0.53 (95% confidence limits 0.390.73). Death rates until the end of follow up were 20 and 48% among patients with treated with band ligation and sclerotherapy, respectively (p < 0.01), with a relative risk of dying for patients subjected to band ligation of 0.41 (95% confidence limits 0.25-0.68).
  
  
  CONCLUSIONS
  Band ligation was associated with lower rates of re-bleeding and mortality in these cohorts of patients.
authors.affiliation: Departamento de Medicina, Universitat Autònoma Barcelona, Spain . edrios@adsl.tie.cl
authors.forename: Eddy
authors.initials: E
authors.lastname: Ríos
authors.forename: Armando
authors.initials: A
authors.lastname: Sierralta
authors.forename: Marigraciela
authors.initials: M
authors.lastname: Abarzúa
authors.forename: Joaquín
authors.initials: J
authors.lastname: Bastías
authors.forename: María Inés
authors.initials: MI
authors.lastname: Barra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002677:Chile / Q000453:epidemiology; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007223:Infant; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015911:Sclerotherapy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult