J Korean Med Sci.  2013 Nov;28(11):1657-1660. 10.3346/jkms.2013.28.11.1657.

Long-term Outcomes of Endoscopic Variceal Ligation to Prevent Rebleeding in Children with Esophageal Varices

• Kang KS
• Yang HR
• Ko JS
• Seo JK

• KMID: 1777665
• DOI: http://doi.org/10.3346/jkms.2013.28.11.1657

Abstract

After an episode of acute bleeding from esophageal varices, patients are at a high risk for recurrent bleeding and death. However, there are few reports regarding the long-term results of secondary prophylaxis using endoscopic variceal ligation (EVL) against variceal rebleeding in pediatrics. Thirty-seven, who were followed for over 3 yr post-eradication, were included in the study. The mean duration of follow up after esophageal variceal eradication was 6.4+/-1.9 yr. The mean time required to achieve the eradication of varices was 3.25 months. The mean number of sessions and O-bands needed to eradicate varices was 1.9+/-1.2 and 3.8+/-1.5, respectively. During the period before the first EVL treatment, 145 episodes of bleedings developed in 37 children. Over the 3 yr of follow-up after variceal eradication, only 4 episodes of rebleeding developed in 4 of 37 patients. The four rebleeding episodes consisted of an esophageal variceal bleed, a gastric variceal bleed, a duodenal ulcer bleed, and a bleed caused by hemorrhagic gastritis. There was no mortality during long-term follow up after variceal eradication. During long-term follow up after esophageal variceal eradication using solely EVL in children with esophageal variceal bleeds, rebleeding episodes and recurrence of esophageal varices were rare. EVL is a safe and highly effective method for the long-term prophylaxis of variceal rebleeding in children with portal hypertension.

Keyword

Ligation; Child; Esophageal and Gastric Varices

MeSH Terms

Child
Duodenum/surgery
Endoscopy/*methods
Esophageal and Gastric Varices/*surgery
Esophagus/surgery
Female
Gastritis/surgery
Gastrointestinal Hemorrhage/*surgery
Humans
Ligation
Male
Recurrence/prevention & control
Retrospective Studies
Treatment Outcome

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