ENDOSCOPIC ULTRASONOGRAPHY IN THE TREATMENT OF ESOPHAGEAL-VARICES BY ENDOSCOPIC SCLEROTHERAPY AND BAND LIGATION - DO WE NEED IT

Objective: To assess the role of endoscopic ultrasonography (EUS) in m onitoring the treatment of oesophageal varices by endoscopic sclerothe rapy and band ligation. Methods: We studied 35 patients with portal hy pertension undergoing elective treatment for oesophageal varices by in jection sclerotherapy with absolute ethanol (group 1, n = 19) or by en doscopic variceal ligation (EVL; group 2, n = 16). All patients were e xamined by EUS before treatment to assess the status of their oesophag o-gastric varices and the presence of collateral and perforating veins . Evaluation with EUS was repeated to confirm variceal eradication whe never endoscopy suggested successful obliteration, or to determine the reason for failure when treatment did not appear to be successful. De pending on the endosonographic findings, treatment was continued until EUS showed complete variceal eradication. Results: After treatment, E US showed insufficient variceal thrombosis in six (17%) patients who a ppeared to have variceal eradication at endoscopy. EUS was also superi or to endoscopy for diagnosing gastric varices and showed patent vesse ls in 26 (74%) out of 35 patients. Gastric varices observed on EUS wer e detected at endoscopy in only 60% of cases. Endoscopic sclerotherapy and EVL had induced characteristic changes on EUS evaluation, and oes ophageal fibrosis was observed more frequently in endoscopic sclerothe rapy than in EVL-treated patients. Conclusion: EUS provides valuable i nformation on the status of oesophago-gastric varices and can be used to assess the efficiency of endoscopic sclerotherapy and EVL.