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Endoscopic clipping versus band ligation in the management of bleeding esophageal varices.
Surg Endosc. 2003 Jan; 17(1):38-42.SE

Abstract

BACKGROUND

The effectiveness of endoscopic clipping in the hemostasis of bleeding esophageal varices and the eventual variceal eradication was compared with that of band ligation.

METHODS

Forty patients were enrolled in the study in a prospective manner, 19 of whom received endoscopic clipping (group I) and the remaining (n = 21 patients) received endoscopic band ligation (group II). All patients in this study presented with bleeding from esophageal varices. The patient characteristics (age, sex, Child-Pugh score, variceal grade) were comparable in the two groups. After initial hemostasis, the patients were assigned one of the two forms of endoscopic therapy which was continued in the follow-up sessions until varices were eradicated. Early and late results were compared.

RESULTS

Initial hemostasis was achieved in all patients in group I but two patients in group II required clip ligation for initial hemostasis because of the failure in band ligation. Those two were treated with band ligation in the follow-up sessions. A total of 224 clips in 53 treatment sessions and 296 bands in 82 treatment sessions were placed in group I and group II, respectively. The rates of complete variceal eradication were 89% and 76% in group I and group II, respectively (p > 0.05). The median number of required treatment sessions for complete eradication of the varices was significantly lower in group I than group II (3 versus 4, p = 0.013). Three patients from group I (15%) and seven patients from group II (33%) were readmitted for variceal bleeding during the follow-up period (p > 0.05).

CONCLUSIONS

With the advantages of high initial hemostasis rate, decreased risk of rebleeding, and fewer treatment sessions needed for variceal eradication, endoscopic clipping is as effective as band ligation, or perhaps more effective in the treatment of bleeding esophageal varices.

Authors+Show Affiliations

Department of General Surgery, Faculty of Medicine, Selçuk University, 42200, Konya, Turkey. serdaryol@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

12364992

Citation

Yol, S, et al. "Endoscopic Clipping Versus Band Ligation in the Management of Bleeding Esophageal Varices." Surgical Endoscopy, vol. 17, no. 1, 2003, pp. 38-42.
Yol S, Belviranli M, Toprak S, et al. Endoscopic clipping versus band ligation in the management of bleeding esophageal varices. Surg Endosc. 2003;17(1):38-42.
Yol, S., Belviranli, M., Toprak, S., & Kartal, A. (2003). Endoscopic clipping versus band ligation in the management of bleeding esophageal varices. Surgical Endoscopy, 17(1), 38-42.
Yol S, et al. Endoscopic Clipping Versus Band Ligation in the Management of Bleeding Esophageal Varices. Surg Endosc. 2003;17(1):38-42. PubMed PMID: 12364992.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic clipping versus band ligation in the management of bleeding esophageal varices. AU - Yol,S, AU - Belviranli,M, AU - Toprak,S, AU - Kartal,A, Y1 - 2002/10/08/ PY - 2002/02/11/received PY - 2002/06/06/accepted PY - 2002/10/5/pubmed PY - 2003/3/4/medline PY - 2002/10/5/entrez SP - 38 EP - 42 JF - Surgical endoscopy JO - Surg Endosc VL - 17 IS - 1 N2 - BACKGROUND: The effectiveness of endoscopic clipping in the hemostasis of bleeding esophageal varices and the eventual variceal eradication was compared with that of band ligation. METHODS: Forty patients were enrolled in the study in a prospective manner, 19 of whom received endoscopic clipping (group I) and the remaining (n = 21 patients) received endoscopic band ligation (group II). All patients in this study presented with bleeding from esophageal varices. The patient characteristics (age, sex, Child-Pugh score, variceal grade) were comparable in the two groups. After initial hemostasis, the patients were assigned one of the two forms of endoscopic therapy which was continued in the follow-up sessions until varices were eradicated. Early and late results were compared. RESULTS: Initial hemostasis was achieved in all patients in group I but two patients in group II required clip ligation for initial hemostasis because of the failure in band ligation. Those two were treated with band ligation in the follow-up sessions. A total of 224 clips in 53 treatment sessions and 296 bands in 82 treatment sessions were placed in group I and group II, respectively. The rates of complete variceal eradication were 89% and 76% in group I and group II, respectively (p > 0.05). The median number of required treatment sessions for complete eradication of the varices was significantly lower in group I than group II (3 versus 4, p = 0.013). Three patients from group I (15%) and seven patients from group II (33%) were readmitted for variceal bleeding during the follow-up period (p > 0.05). CONCLUSIONS: With the advantages of high initial hemostasis rate, decreased risk of rebleeding, and fewer treatment sessions needed for variceal eradication, endoscopic clipping is as effective as band ligation, or perhaps more effective in the treatment of bleeding esophageal varices. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/12364992/Endoscopic_clipping_versus_band_ligation_in_the_management_of_bleeding_esophageal_varices_ L2 - https://doi.org/10.1007/s00464-002-9033-1 DB - PRIME DP - Unbound Medicine ER -