title: Endoscopic ultrasound findings predict the recurrence of esophageal varices after endoscopic band ligation: a prospective cohort study.
abstract: OBJECTIVE
  Variceal recurrence following endoscopic band ligation (EBL) is common. Esophageal collateral veins (ECV) are observed by endoscopic ultrasound (EUS) in patients with portal hypertension. The aim of the present study was to assess the role of EUS in predicting the recurrence of esophageal varices following EBL.
  
  
  METHODS
  Forty patients who had undergone EBL for eradication of varices were examined over a 12-month period to detect variceal recurrence. EUS was performed before ligation to detect and describe the type, grade, and the number of ECV. EUS findings obtained prior to EBL were compared in the variceal recurrence and non-recurrence groups.
  
  
  RESULTS
  Of the 40 patients, 19 (47.5%) had variceal recurrence within 12 months of EBL. Univariate logistic regression analysis showed that severe peri-ECV (p < 0.001), multiple peri-ECV (p < 0.001), and the presence of perforating veins (p < 0.014) were statistically significantly related to the variceal recurrence after EBL. Multivariate logistic regression model found that only severe peri-ECV (odds ratio [OR] = 24.39; 95% confidence interval [CI]: 2.34-253.78) and multiple peri-ECV (OR = 24.39; 95% CI: 2.34-253.78) remained as independent prognostic factors for variceal recurrence. The sensitivity and specificity of multivariate logistic regression model in predicting variceal recurrence was 89.2% and 90.5%, respectively (prognostic value (AUC) = 0.946).
  
  
  CONCLUSIONS
  Recurrence rate of esophageal varices after EBL is high (47.5%). EUS can clearly depict ECV and has a value in predicting variceal recurrence after EBL; severe peri-ECV and multiple peri-ECV were significant and independent prognostic factors associated with variceal recurrence risk.
authors.affiliation: Clinic of Gastroenterology, Nephrourology and Surgery, Medical Faculty, Vilnius University , Universiteto str. 3, LT-01513, Vilnius , Lithuania.
authors.forename: Laura
authors.initials: L
authors.lastname: Masalaite
authors.forename: Jonas
authors.initials: J
authors.lastname: Valantinas
authors.forename: Juozas
authors.initials: J
authors.lastname: Stanaitis
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy; D019160:Endosonography; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000601:surgery*; D004947:Esophagus; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D008026:Ligation; D008103:Liver Cirrhosis / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D012307:Risk Factors
keywords: Endoscopic band ligation; endoscopic ultrasound; variceal recurrence