Evaluation of endoscopic injection sclerotherapy with and without simultaneous ligation for the treatment of esophageal varices

For more effective and simple endoscopic injection sclerotherapy (EIS) for esophageal varices, we developed an EIS procedure with ligation (EISL) that is non-invasive, in which EIS and endoscopic variceal ligation (EVL) are p erformed simultaneously. In this study, we compared EISL and EIS in a rando mlized sample of patients (n = 14 for each procedure). For EISL, EVL was pe rformed, including the injection site, after the injection of 5% ethanolami ne oleate with iopamidol (EOI) into a varix. The mean number of treatment s essions required for eradication of esophageal varices was 2.3 +/- 0.5 for EISL and 3.9 +/- 0.8 for EIS (P < 0.001); the mean number of treatment site s was 6.2 +/- 2.2 for EISL and 14.0 +/- 5.0 for EIS (P < 0.001); the mean t otal amount of EOI used was 13.8 +/- 5.2 ml for EISL and 26.3 +/- 9.8 mi fo r EIS (P < 0.001). There were no significant differences in rates of recurr ence of varices or in bleeding between the two groups. For EISL, fewer trea tment sessions and less sclerosant were sufficient, probably because the sc lerosants were more effective due to the blockage of variceal blood flow by the ligation. This method should provide a novel modification of EIS.