Abstract
Objective:To determine number of sessions of Endoscopic variceal band ligation required to obliterate the esophageal varices.Methods:This study was conducted at Civil Hospital Karachi between June 2018 to April 2019. All patients undergoing endoscopic Variceal Band Ligation (EVBL) were inducted. Number of sessions of band ligation required to obliterate the varices were recorded. Number of EVBL sessions were correlated with Child-Pugh’s Score and etiology of CLD by χ2 test, while it was compared with duration of Chronic Liver Disease (CLD) by One-way ANOVA test.Results:One hundred ninety-two patients fulfilling selection criteria were admitted after informed consent. These included 101 (52.6%) males and 91 (47.4%) females. Most common cause of cirrhosis was HCV (66.7%) in our patients. Most of the patients were in Child Class-B (71.9%). Majority of patients (52.6%) underwent 3 sessions of EVBL while 68 (35.4%) underwent 4 sessions of EVBL. Duration of CLD was analyzed with number of sessions of EVBL by One-Way ANOVA test and it showed significant more sessions of EVBL were done with longer duration of CLD (p <0.001).Conclusion:Most patients underwent 3-4 sessions of EVBL for obliteration of varices. Number of EVBL sessions increased significantly with duration of disease.
Highlights
Variceal bleeding is a serious life-threatening complication of portal hypertension.[1]
Portal hypertension is part of a dynamic process triggered by chronic liver disease
In decompensated cirrhosis portal hypertension is a serious problem and it may present as ascites, splenomegaly and esophageal varices.[3]
Summary
Variceal bleeding is a serious life-threatening complication of portal hypertension.[1] Portal hypertension is part of a dynamic process triggered by chronic liver disease. Hepatitis C (HCV) is the commonest cause of cirrhosis in our part of the world.[5] About 50% of the cirrhotic patients develop esophageal varices and among them 35% will die in their first episode.[7] There are different grades of varices and they may be classified as small, medium and large varices.[8] Endoscopic Variceal Band Ligation (EVBL) is effective mode to treatment to arrest active bleed, but in eradication of varices. Our objective was to determine the number of sessions of EVBL required to eradicate the esophageal varices in cirrhotic patients. This study will help in better understanding of this disease in our settings and better formulation of management and prediction plans in our population
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