Acombined approach to control oesophaoeal varices bx endoscopic Band ligation and sclerotherapx.
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Injection sclerotherapy is the most widely used definitive treatment of acute variceal bleeding. Endoscopic band ligation (EVL) is an alternative to endoscopic sclerotherapy (ES) for primary and secondary prophylaxis of variceal bleeding. It was :foundithat it is safe and less complicated than sclerotherapy, but ^recurrence • rate is relatively higher than sclerotherapy. ' Also, 1 sclerotherapy has cirmulatiye_cgmplicated_effects. This leads us to try combine'sclerotherapy and EVL in^one session, and continued by repeated EVL to take the advant^cjei^^sclerotherapy in obirteratrng the varices and perforators and/safety of EVL. For this reasons 42 patients were selected for this purp'ose (age 44.3 9.2). Twenty four (10 EVL and 14 Combined) for 2ry_ prophylaxis and 18 patients (10 combined and 8 EVL) for emergency hematemesis. These patients were followed up for 9 months after obliteration of the varices (range 6-11 months). We have found that' comb^nation is effective as EVL in obliterating varices with few complications as EVL alone but no statistically significant difference was found except retrosternal pain which is more and significant in combination group than EVL alone. The recurrence rate of varices is also less than EVL (one case in combined group i/24 and 3 cases in EVL group 3/18). But for more evalua'tion of this combination for recurrence of varices it needs follow up for longer period than this short period of follow up.