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Esophageal Varices Ligation (EVL) Versus Esophageal Variceal Sclerotherapy (EVS) in Esophageal Bleeding in Liver Cirrhosis

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Simadibrata, Marcellus MD, PhD; Syam, Ari Fahrial MD; Fauzi, Mohamad MD; Abdullah, Murdani MD; Dadang, Makmun MD

American Journal of Gastroenterology: September 2006 - Volume 101 - Issue - p S46
Abstracts: ESOPHAGUS
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Gastroenterology Internal Medicine, University of Indonesia/Cipto Mangun Kusumo Hospital, Jakarta, Java Island, Indonesia.

Purpose: The most frequent cause of upper gastrointestinal bleeding in Indonesia is rupture of esophageal varices. Recently EVL is classified as the best treatment to eradicate esophageal varices. This study was done to know the differences between EVL and EVS outcome in the treatment of esophageal variceal bleeding.

Methods: All medical reports of upper gastrointestinal bleeding due to rupture of esophageal varices in liver cirrhosis who were done EVL or EVS in the year 2003 – 2006 were included in this study. Exclusion if the data was incomplete. Patients were divided into three groups, who were done: EVL alone, EVS alone, and combination of EVL- EVS. Data were assessed with chi-square test or anova.

Results: We got 96 (75.6%) cases who were done EVL, 23 (18.1%) cases who were done EVS and 8 (6.3%) who were done combination of EVL-EVS. There were no differences of patients characteristics between this three groups statistically. The complications of the EVL group (29.2%) is less frequent than the complications in the EVS (60.9%) or combination EVL-EVS (37.5%). The mean duration of admission in the hospital after the procedure of EVL, EVS, Combination EVL-EVS were 11.83 ± 11.23 days, 13.86 ± 10.18 days and 14.25 ± 12.82 days, respectively. The mean survival of patients who were done EVL, EVS and combination EVL-EVS are 463.05 ± 409.20 days, 200.25 ± 303.51 days, and 32.50 ± 38.89 days, respectively.

Conclusions: EVL is still the best treatment for esophageal varices bleeding. EVL has the lowest complications and the longest duration of patients survival.

© The American College of Gastroenterology 2006. All Rights Reserved.