Endoscopic Injection Sclerotherapy And Endoscopic Variceal Ligation For The Treatmentof Esophagealvaricesbleeding

Background and AimThe aim of this study was to compare the effectiveness and safety of Esophageal Injection Sclerotherapy(EIS)with Esophageal Variceal Ligation(EVL)in the management of Esophageal Variceal Bleeding(EVB).Materials and MethodsIn this pending study,the treatment effects of EIS and EVL were comparedin a number of one hundred and twenty four patients withproven endoscopic bleeding from esophageal varices.With reference to various methods of treatment;patients were spontaneously divided into:either the EIS orEVL group.64 patients were treated with sclerotherapy,and the remaining 60 with ligation.Patients were evaluated for a 2 year period,in which time we deduced the complications and bleeding recurrences that occurred.Along withthe required number of treatment sessionsthat would result in variceal eradication;mortality and survival rates.ResultsThe first treatment of EIS:controlled active bleeding in 19 of 19 patients(100%).EVL too was 16 of 16 patients(100%).Early re-bleeding rate in EIS-treated patients was minimally declined(7.8%vs 11.7%,P=0.47)late re-bleeding rate was minimally elevated in EIS-treated patients(28.1%vs 23.3%,P=0.54)-statisticallyinsignificant.The variceal eradication rate in the EIS group was minimally declined to theEVL group-(79.7%vs 86.7%,P=0.30).Mortality rate(1.6%vs 3.3%,P=0.61)and survival rate(71.9%vs 78.3%,P=0.41)were not significantly different-(all P>0.05).However,fever in the EIS group was significantly higher as compared to that of the EVL group(n=17,26.6%vs n=6,10.0%,p=0.02).Except fever,no differences were found in complications between the two groups.No perforation,Mediastinitis,Chylous effusions or ARDS were observed in the two groups.ConclusionBoth EIS and EVL:produce excellent results,are safe,effective,feasible and acceptable for EVB with minimum complications and difficulties of subsequent procedures in the short-term.For a better decision,we should take into consideration:the hospital conditions,operator experience as well as the esophageal varices and their characteristics.