Background: Endoscopic band ligation (EBL) is generally accepted as the treatment of choice for bleeding from
esophageal varices. It is also used for secondary prophylaxis of esophageal variceal hemorrhage. However, there is
no data or guidelines concerning endoscopic control of ligation ulcers. We conducted a retrospective study of EBL
procedures analyzing bleeding complications after EBL.
Methods: We retrospectively analyzed data from patients who underwent EBL. We analyzed several data points,
including indication for the procedure, bleeding events and the time interval between EBL and bleeding.
Results: 255 patients and 387 ligation sessions were included in the analysis. We observed an overall bleeding rate
after EBL of 7.8%. Bleeding events after elective treatment (3.9%) were significantly lower than those after
treatment for acute variceal hemorrhage (12.1%). The number of bleeding events from ligation ulcers and variceal
rebleeding was 14 and 15, respectively. The bleeding rate from the ligation site in the group who underwent
emergency ligation was 7.1% and 0.5% in the group who underwent elective ligation. Incidence of variceal
rebleeding did not vary significantly. Seventy-five percent of all bleeding episodes after elective treatment occurred
within four days after EBL. 20/22 of bleeding events after emergency ligation occured within 11 days after
treatment. Elective EBL has a lower risk of bleeding from treatment-induced ulceration than emergency ligation.
Conclusions: Patients who underwent EBL for treatment of acute variceal bleeding should be kept under medical
surveillance for 11 days. After elective EBL, it may be reasonable to restrict the period of surveillance to four days
or even perform the procedure in an out-patient setting.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa.de:bsz:15-qucosa-77473 |
| Date | 20 October 2011 |
| Creators | Petrasch, Florian |
| Contributors | Universität Leipzig, Medizinische Fakultät, Dr.med. Albrecht Hoffmeister, Prof. Dr. med. Joachim Mössner, Prof. Dr. med. Alexander Gerbes |
| Publisher | Universitätsbibliothek Leipzig |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | deu |
| Detected Language | English |
| Type | doc-type:doctoralThesis |
| Format | application/pdf |
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