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. |
