Introduction. Endoscopic band ligation (EBL) is superior to endoscopic
injection sclerotherapy (EIS) of oesophageal varices, however, EBL is
associated with a higher rate of variceal recurrences. Objective. To examine
whether the reduction of recurrent varices can be achieved by additional
sclerotherapy of remnant little varices after ligation. Methods. Forty-eight
patients with liver cirrhosis who had previously bled from oesophageal
varices were examined. Endoscopic therapy was performed in order to prevent
recurrent variceal bleeding. I group: in 23 patients ligation of oesophageal
varices with multi band ligation device was applied (EBL group). II group: in
25 patients sclerotherapy using polydocanol or absolute alcohol was applied
after reducing the size of varices using ligation (EBL and EIS group).
Results. There was no statistically significant difference between the
examined groups of patients in relation to the number of sessions for
variceal eradication, recurrence of variceal bleeding, deterioration of
portal gastropathy and mortality in the observed period from 18.8?18.6 months
(EBL group) and 22.2?26.2 months (EBL and EIS group). Variceal recurrence was
verified in 21.7% of patients of the EBL group and 16% of the EBL and EIS
group, but the difference was not statistically important. Several
complications, such as dysphagia and chest pain, were statistically more
frequent in the EBL and EIS group of patients. Conclusion. The combined
method of ligation and extra sclerosing of remnant small oesophageal varices
after ligation does not have advantage in relation to the ligation alone.
Role of band ligation for secondary prophylaxis of variceal bleeding
