Premium
An Improved Endoscopic Variceal Ligator for Esophagogastric Varix
Author(s) -
SHIBUYA Susumu,
KAWASHIMA Takahiko,
CHIKAMORI Fumio,
EDA Hiroyuki,
AOYAGI Hiroyuki,
TAKASE Yasuhiro,
NAKAHARA Akira,
FUKUTOMI Hisayuki,
TANAKA Naomi
Publication year - 1997
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1997.tb00454.x
Subject(s) - medicine , gastric varices , esophageal varices , varices , varix , ligation , endoscopy , esophagus , gastroenterology , sclerotherapy , surgery , radiology , portal hypertension , cirrhosis
We recently reported a 16.0 mm in length new type of instrument with an inner cylinder of 10.3 mm for endoscopic variceal ligation (EVL). This device is capable of shooting three elastic O bands consecutively in rapid succession without removing the endoscope. The aspirated volume of variceal tissue with the new instrument is larger than that obtained with the Stiegmann ligator. We performed EVL in 16 cases with esophageal varices and seven with solitary gastric varices. EVL was performed for prophylaxis in all cases. The esophageal varices disappeared in all 16 cases after ulcer formation. The procedure was performed once in 14 cases and twice in the remaining two. Three patients died of hepatic failure during the follow‐up period which ranged from four to 16 months. Six and 12 month cumulative recurrence rates were 30% and 48%, respectively. All gastric varices disappeared after a single EVL session. There was one variceal recurrence during the follow‐up period. Computed tomography and/ or arterioportography performed previously had shown patent gastro‐renal shunt in five cases. No changes in the shunts were observed after treatment. No serious complications attributable to EVL were encountered in this series. Therefore, this method is potentially useful for the treatment of not only esophageal varices but also gastric varices.