Saudi Journal of Gastroenterology
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Year : 2011  |  Volume : 17  |  Issue : 2  |  Page : 105-109

Variceal band ligation in the prevention of variceal bleeding: A multicenter trial

1 Department of Gastroenterology, Habib Thameur Hospital, Tunis, Tunisia
2 Department of Gastroenterology, Military Hospital, Tunis, Tunisia
3 Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
4 Department of Gastroenterology, Maamouri Hospital, Nabeul, Tunisia
5 Department of Gastroenterology, B, La Rabta Hospital, Tunis, Tunisia
6 Department of Gastroenterology, Charles Nicolle Hospital, Tunis, Tunisia
7 Department of Gastroenterology, Fattouma Bourguiba Hospital, Monastir, Tunisia
8 Department of Gastroenterology, Mongi Slim Hospital, Tunis, Tunisia

Correspondence Address:
Asma Ouakaa-Kchaou
Department of Gastroenterology, Habib Thameur Hospital, 8 Rue Ali Ben Ayed Montfleury 1008, Tunis
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-3767.77238

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Background/Aim: Variceal bleeding is a life-threatening complication of portal hypertension with a high probability of recurrence. Treatment to prevent first bleeding or rebleeding is mandatory. The study has been aimed at investigating the effectiveness of endoscopic band ligation in preventing upper gastrointestinal bleeding in patients with portal hypertension and to establish the clinical outcome of patients. Patients and Methods: We analyzed in a multicenter trial, the efficacy and side effects of endoscopic band ligation for the primary and secondary prophylaxis of esophageal variceal bleeding. We assigned 603 patients with portal hypertension who were hospitalized to receive treatment with endoscopic ligation. Sessions of ligation were repeated every two to three weeks until the varices were eradicated. The primary end point was recurrent bleeding. Results: The median follow-up period was 32 months. A total of 126 patients had recurrent bleeding. All episodes were related to portal hypertension and 79 to recurrent variceal bleeding. There were major complications in 51 patients (30 had bleeding esophageal ulcers). Seventy-eight patients died, 26 deaths were related to variceal bleeding and 1 to bleeding esophageal ulcers. Conclusions: A great improvement in the prevention of variceal bleeding has emerged over the last years. However, further therapeutic options that combine higher efficacy, better tolerance and fewer side effects are needed.

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