Abstract
Endoscopic variceal ligation (EVL), a safe and effective treatment for esophageal varices, has undergone rapid progress since its invention. One of the greatest advantages of EVL over endoscopic injection sclerotherapy (EIS) is its versatile adaptability, particularly for high-risk populations such as elderly patients. Originally, the “Stiegmann-Goff Ligator Kit” (Bard Co., USA) used for the EVL procedure was equipped with a wire to remove the ligature bands from the endoscope. In Japan, the modified pneumo-activated EVL device (Sumitomo Bakelite Co. Ltd.) was invented and came into common use. These single-band ligators require an over-tube to ligate esophageal varices. However, we now use a multi-band ligator without an over-tube to perform ligations in rapid succession. This chapter contains an outline description of the multi-band ligator comparing with the single-band ligator.
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References
Fukui H, Saito H, Ueno Y, et al. Evidence-based clinical practice guidelines for liver cirrhosis 2015. J Gastroenterol. 2016;51:629–50.
D’Amico G, Morabito A. Noninvasive markers of esophageal varices: another round, not the last. Hepatology. 2004;39:30–4.
Garcia-Tsao G, Sanyal AJ, Grace ND, et al. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007;46:922–38.
Feu F, García-Pagán JC, Bosch J, et al. Relation between portal pressure response to pharmacotherapy and risk of recurrent variceal haemorrhage in patients with cirrhosis. Lancet. 1995;346:1056–9.
D’Amico G, Garcia-Pagan JC, Luca A, et al. Hepatic vein pressure gradient reduction and prevention of variceal bleeding in cirrhosis: a systematic review. Gastroenterology. 2006;131:1611–24.
Burroughs AK, Triantos CK. Predicting failure to control bleeding and mortality in acute variceal bleeding. J Hepatol. 2008;48:185–8.
Ideo G, Bellati G, Fesce E, et al. Nadolol can prevent the first gastrointestinal bleeding in cirrhotics: a prospective, randomized study. Hepatology. 1988;8:6–9.
Garden OJ, Mills PR, Birnie GG, et al. Propranolol in the prevention of recurrent variceal hemorrhage in cirrhotic patients. A controlled trial. Gastroenterology. 1990;98:185–90.
Schepke M, Kleber G, Nurnberg D, et al. Ligation versus propranolol for the primary prophylaxis of variceal bleeding in cirrhosis. Hepatology. 2004;40:65–72.
Stiegmann GV, Goff JS, Michaletz Onody PA, et al. Endoscopic sclerotherapy as compared with endoscopic ligation for bleeding esophageal varices. N Engl J Med. 1992;326:1527–32.
Gimson AES, Ramage JK, Panos MZ, et al. Randomized trial of variceal banding ligation versus injection sclerotherapy for bleeding esophageal varices. Lancet. 1993;342:391–4.
Laine L, El-Newihi HM, Migikovsky B, et al. Endoscopic ligation compared with sclerotherapy for the treatment of bleeding esophageal varices. Ann Intern Med. 1993;119:1–7.
Hou MC, Lin HC, Kuo BIT, et al. Comparison of endoscopic variceal injection sclerotherapy and ligation for the treatment of esophageal variceal hemorrhage: a prospective randomized trial. Hepatology. 1995;21:1517–22.
Sarin SK, Govil A, Jain AK, et al. Prospective randomized trial of endoscopic sclerotherapy versus variceal band ligation for esophageal varices: influence on gastropathy, gastric varices and variceal recurrence. J Hepatol. 1997;26:826–32.
Baroncini D, Milandri GL, Borione D, et al. A prospective randomized trial of sclerotherapy versus ligation in the treatment of bleeding esophageal varices. Endoscopy. 1997;29:235–40.
Takeuchi M, Nakai Y, Sha S, et al. Combined ligation and paravariceal injection sclerotherapy for esophageal varices: outcome over 3 years. Gastroenterol Endosc. 1997;39:1189–95.
Jia Y, Dwivedi A, Elhanafi S, et al. Low risk of bacteremia after endoscopic variceal therapy for esophageal varices: a systematic review and meta-analysis. Endosc Int Open. 2015;03(05):409–17.
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© 2019 Springer Nature Singapore Pte Ltd.
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Suzuki, Y., Murashima, N. (2019). Endoscopic Treatment of Esophageal Varices: Endoscopic Variceal Ligation Using a Multi-Band Ligator. In: Obara, K. (eds) Clinical Investigation of Portal Hypertension. Springer, Singapore. https://doi.org/10.1007/978-981-10-7425-7_28
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DOI: https://doi.org/10.1007/978-981-10-7425-7_28
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