title: Long-term outcomes of endoscopic variceal ligation to prevent rebleeding in children with esophageal varices.
abstract: After an episode of acute bleeding from esophageal varices, patients are at a high risk for recurrent bleeding and death. However, there are few reports regarding the long-term results of secondary prophylaxis using endoscopic variceal ligation (EVL) against variceal rebleeding in pediatrics. Thirty-seven, who were followed for over 3 yr post-eradication, were included in the study. The mean duration of follow up after esophageal variceal eradication was 6.4±1.9 yr. The mean time required to achieve the eradication of varices was 3.25 months. The mean number of sessions and O-bands needed to eradicate varices was 1.9±1.2 and 3.8±1.5, respectively. During the period before the first EVL treatment, 145 episodes of bleedings developed in 37 children. Over the 3 yr of follow-up after variceal eradication, only 4 episodes of rebleeding developed in 4 of 37 patients. The four rebleeding episodes consisted of an esophageal variceal bleed, a gastric variceal bleed, a duodenal ulcer bleed, and a bleed caused by hemorrhagic gastritis. There was no mortality during long-term follow up after variceal eradication. During long-term follow up after esophageal variceal eradication using solely EVL in children with esophageal variceal bleeds, rebleeding episodes and recurrence of esophageal varices were rare. EVL is a safe and highly effective method for the long-term prophylaxis of variceal rebleeding in children with portal hypertension.
authors.affiliation: Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. ; Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea.
authors.forename: Ki Soo
authors.initials: KS
authors.lastname: Kang
authors.forename: Hye Ran
authors.initials: HR
authors.lastname: Yang
authors.forename: Jae Sung
authors.initials: JS
authors.lastname: Ko
authors.forename: Jeong Kee
authors.initials: JK
authors.lastname: Seo
mesh_terms: D002648:Child; D004386:Duodenum / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D004947:Esophagus / Q000601:surgery; D005260:Female; D005756:Gastritis / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D006801:Humans; D008026:Ligation; D008297:Male; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome
keywords: Child; Esophageal and Gastric Varices; Ligation