Comparison Between Argon Plasma Coagulation And Endoscopic Band Ligation InTreatment Of Gastric Antral Vascular Ectasia In Egyptian Cirrhotic Patients

Abstract

Background and study aim: The Gastric antral vascular ectasia (GAVE) is one of the causes of upper gastrointestinal bleeding and accounts nearly four percent of all non-variceal upper gastrointestinal hemorrhage. Although Argon Plasma Coagulation is the standard treatment of GAVE, EBL may be used in the treatment of GAVE. This study was done to evaluate the therapeutic effect of APC in comparison to EBL for the treatment of bleeding GAVE in cirrhotic patients. Patients and Methods: Our study was conducted on 36 adult cirrhotic patients with bleeding from GAVE. Patients were divided into 2 groups: 18 patients in each group. Group I was subjected to APC and group II was subjected to EBL. All patients were followed endoscopically after the first endoscopic intervention for 6 months as well as their hemoglobin level had been evaluated monthly during that period. Results: There was a statistically non-significant difference between both treatment groups as regards cessation of bleeding, increase in hemoglobin levels, reduction of transfusion requirements, decreasing of hospital admissions or decreasing of endoscopic recurrence of GAVE during the follow-up period (6 months), but EBL group has a better result than APC group. The application of the EBL technique has significantly increased in the band related complications as hypertrophied polyps and post band ulcerations, which are decreased in the following sessions, in comparison to the APC technique, which had no complications-related. Conclusion: EBL and APC are effective methods in the treatment of bleeding GAVE in cirrhotic patients.