ENDOSCOPIC LIGATION FOR BLEEDING ESOPHAGE AL-VARICES - CLINICAL PROSPECTIVE-STUDY OF 50 PATIENTS

Objectives: Endoscopic sclerotherapy is effective to prevent bleeding of oesophageal varices but is associated with frequent adverse effects , Endoscopic ligation represents a new endoscopic alternative treatmen t to sclerotherapy, The purpose of this study was to assess efficacy a nd safety of endoscopic variceal ligation in 50 consecutive patients w ith cirrhosis who had recently bled from oesophageal varices, Methods: Patients were followed from 6 to 1140 days (median 310 days), Nine pa tients were bleeding actively when ligation was performed, Results: El even patients (22%) had 13 recurrent bleedings requiring blood transfu sion during follow-up, Six recurrences occurred during the first month (3 from bleeding varices, 3 treatment-induced); seven recurrences occ urred latter (6 from bleeding varices, 1 treatment-induced). Varices w ere eradicated in 33 patients (66% of all patients, 82% of patients wh o survived more than 30 days). Variceal eradication was achieved in 2- 9 endoscopic Ligation sessions (median 3), Eighteen patients died duri ng the study; one died from bleeding, No patient developed major compl ications; five patients only complained of mild dysphagia for 24 to 48 hours, Conclusion: Endoscopic Ligation is a safe and effective method to prevent recurrent bleeding from oesophageal varices.