Abstract
IntroductionLong-term outcome of patients after band ligation have been poorly defined. Therefore, we conducted a long-term follow-up study to delineate the outcome of ligation in patients with portal hypertension in the Hassan II university hospital, Fes, Morocco.MethodsOver 118 months patients treated by endoscopic variceal ligation were received regular follow- up and detailed clinical assessment of at least 24 months.ResultsOne hundred twenty five patients were followed up for a mean of 31 months (range 12-107 months). Obliteration of the varices was achieved in 89.6 % (N = 112) of patients, with 3 +/-1.99 (range 1-8) endoscopy sessions over a period of 14 + /-6.8 weeks (range 3-28). The percentage of variceal recurrence during follow-up after ligation was 20.5 % (N = 23). Recurrence were observed in a mean of 22 months +/- 7.3 (range 3-48). Bleeding rate from recurrent varices was 30.4 % (7/23). Rebleeding from esophageal ulcers occurred in 5.6 % (7/125) of patients. Portal hypertensive gastropathy before and after eradication of varices was 17.6% (N = 22) and 44.6% (N = 50) respectively; p< 0.05. Fundal gastric varices was 30.4% (N = 38) and 35.7% (N = 40) before and after eradication of varices respectively; p> 0.05. The overall mortality was 4 % (N = 5).ConclusionBand ligation was an effective technical approach for variceal obliteration with low rates of variceal recurrence, rebleeding and development of gastric varices. Furthermore, it was associated with frequent development of portal hypertensive gastropathy.
Highlights
Long-term outcome of patients after band ligation have been poorly defined
Endoscopic variceal ligation (EVL) has changed the outlook for patients with upper gastro intestinal bleeding. It is widely accepted as the optimum endoscopic treatment for esophageal variceal in the secondary prevention of esophageal variceal bleeding (EVB) [9]
The rebleeding course and long-term outcome of patients with EVB after ligation have been poorly defined. The aim of this retrospective study was to delineate the long term outcome of band ligation in patients with portal hypertension and who have already bled from their varices and treated by EVL
Summary
Long-term outcome of patients after band ligation have been poorly defined. we conducted a long-term follow-up study to delineate the outcome of ligation in patients with portal hypertension in the Hassan II university hospital, Fes, Morocco. Conclusion: Band ligation was an effective technical approach for variceal obliteration with low rates of variceal recurrence, rebleeding and development of gastric varices It was associated with frequent development of portal hypertensive gastropathy. Recurrent bleeding is common without prophylactic treatment [4]; this risk varies between 8 and 35% within 2 years of follow up [5,6], and an early rebleeding rate of 40-60% was noted within 7 and 10 days of a controlled index episode [2,7] This indicates that a correct therapeutic approach should be aimed at arresting the acute variceal bleeding episode and at preventing an early variceal bleeding [8].
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