Abstract
Background and aim: Endoscopic variceal ligation (EVL) is one of the best modalities for treatment of esophageal varices. One of the most serious complications after EVL is post-banding ulcer bleeding. In this study, frequency and risk factors of EVL-induced ulcer bleeding were assessed. Methods: One hundred and twenty six patients with liver cirrhosis subjected to EVL, whether done as prophylactic or therapeutic, were followed up for two weeks for detection of occurrence of post-banding ulcer bleeding. A prospective cohort study was performed comparing the patients that bleed after EVL due to post-banding ulcer (bleeder group, n= 10) with those without this complication (non-bleeder group, n= 116). All patients received full medical history taking; complete physical examination; routine laboratory tests; Pelvi-abdominal ultrasonography; Esophago-gastro-duodenoscopy (EGD) and EVL; treatment with blood transfusion and pharmacologic agents; re-endoscopy if rebleeding occur after EVL. Results: Frequency of post–banding ulcer bleeding after EVL in patients who have liver cirrhosis was 7.9%, and its mortality within 14 days follow up was 10%. Reflux esophagitis was found to be a risk factor of post- banding ulcer bleeding (P= 0.016, OR= 8). Proton pump inhibitor (PPI) may be a protective factor against occurrence of post-banding ulcer bleeding (P= 0.054). Conclusion: Post-banding ulcer bleeding is an infrequent complication after EVL. Reflux esophagitis is considered an independent risk factor for this complication.
Highlights
Esophageal variceal bleeding represents the most vital complication among patients with liver cirrhosis at a rate of 5-15% per year
Early rebleeding after Endoscopic variceal ligation (EVL) was reported in about 3.6% to 15% of patients [7,8,9]
Post-banding ulcer bleeding following EVL was observed in 7.9% (10 out of 126) of patients (Figure 1)
Summary
Esophageal variceal bleeding represents the most vital complication among patients with liver cirrhosis at a rate of 5-15% per year. Bleeding prevention from esophageal varices (EV) remains the fundamental in long-term management of patients with liver cirrhosis. Of the best modalities used in EV treatment [3] It aims to obliterate the varix by inducing ulceration with scar tissue formation [4]. It is considered safe, EVL has few complications [5]. Post ligation pain and esophageal stricture formations were the most frequent reported complications [6,7]. Endoscopic variceal ligation (EVL) is one of the best modalities for treatment of esophageal varices. Frequency and risk factors of EVL-induced ulcer bleeding were assessed
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
