Korean J Hepatol.  1998 Jun;4(2):143-150.

Comparison of Endoscopic Variceal Ligation versus Combined Ligation and Sclerotherapy for Bleeding Esophageal Varices

• Shin KH
• Lee JS
• Yoon JH
• Han CJ
• Lee HS
• Kim CY

Abstract

BACKGROUND/AIMS
Combined esophageal variceal ligation and sclerotherapy has been hypothesized to be more effective for the control of bleeding esophageal varices than ligation alone. The present study was to compare the combined therapy with ligation alone in terms of variceal eradication, rebleeding, complication and survival rates in patients with bleeding esophageal varices.
METHODS
Thirty-eight patients with bleeding esophageal varices were randomly assigned to receive ligation alone in 20 patients or the combined therapy in 18 patients. The clinical and endoscopic characteristics of patients in the ligation group were similar to those of patients in the combination group. In the combination group, 1-3 mL of ethanolamine was injected proximal to each ligated site. Treatments were repeated every 2- to 3-month until varices were eradicated.
RESULTS
No significant differences were found between the ligation and combination groups in variceal eradication rates (70% vs. 72%), numbers of endoscopic sessions required to achieve eradication (3.5+/-0.33 vs. 3.3+/-0.31), rebleeding rates (30% vs. 28%) or 2-yr cumulative survival rates (95% vs. 75%). There were significantly more complications in the combination group (25% vs. 89%, p=0.001).
CONCLUSION
Ligation alone is recommended rather than the combined ligation and sclerotherapy because of its lower complication rates.

Keyword

Esophageal varices; Endoscopic variceal ligation; Endoscopic sclerotherapy; Combined therapy

MeSH Terms

Esophageal and Gastric Varices*
Ethanolamine
Hemorrhage*
Humans
Ligation*
Sclerotherapy*
Survival Rate
Varicose Veins
Ethanolamine