Outcome of Endoscopic Variceal Band Ligation

  • Barun Shrestha Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
  • Sudhamshu KC Hepatology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
  • Sita Ram Chaudhary Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
  • Bhupendra Kumar Basnet Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
  • Amrendra Kumar Mandal Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal
  • Nandu Silwal Poudyal Gastroenterology Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal

Abstract

Introduction: Bleeding from esophageal varices in cirrhosis is an emergent condition with high mortality. One of the preferred modality of treating esophageal varices is EVL. We aimed to find out the outcome of EVL in controlling acute esophageal variceal bleeding, prophylactic banding to prevent future bleeding and the number of sessions required for complete eradication of varices.
Methods: This descriptive observational study was carried out in Gastroenterology and Hepatology unit of Bir Hospital, NAMS from June 2016 to May 2017. Consecutive cases who presented in emergency room with acute variceal bleeding due to liver cirrhosis and cases of liver cirrhosis with large varices and red color signs on endoscopic examination were enrolled. They underwent EVL and subsequent re-endoscope at one month interval till the eradication of varices was achieved. 
Results: Among 83 patients, 15 (18.1%) were of Child Pugh class A, 29 (34.9%) B and 39 (47%) were of C. In 20 (24.1%) cases varices could be eradicated in one session of EVL while 57 (68.7%) required two sessions and in 6 (7.2%) cases it took three sessions. Total average EVL session required for obliteration of esophageal varices was 1.84±0.53. There was only one (1.2%) of early re-bleeding post EVL.
Conclusions: EVL is an effective modality of treatment in controlling acute esophageal variceal bleeding, in preventing future variceal bleeding as well as in eradicating esophageal varices, with very few complications.
Keywords: acute variceal bleeding; cirrhosis; endoscopic variceal ligation; large varices; red color sign. [PubMed]

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Published
2017-06-28
How to Cite
SHRESTHA, Barun et al. Outcome of Endoscopic Variceal Band Ligation. Journal of Nepal Medical Association, [S.l.], v. 55, n. 206, june 2017. ISSN 1815-672X. Available at: <http://jnma.com.np/jnma/index.php/jnma/article/view/3131>. Date accessed: 20 aug. 2017.
Section
Original Article

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