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Endoscopic Treatment of Esophageal Varices: Bimonthly Endoscopic Variceal Ligation

  • Hiroshi YoshidaEmail author
  • Hiroshi Makino
  • Tadashi Yokoyama
  • Hiroshi Maruyama
  • Atsushi Hirakata
  • Junji Ueda
  • Hideyuki Takata
  • Yasuhiro Mamada
  • Nobuhiko Taniai
  • Eiji Uchida
Chapter

Abstract

Endoscopic variceal ligation (EVL) is being used increasingly to treat esophageal varices because of its safety and simplicity and because no sclerosant is required. However, early recurrence of esophageal varices after this procedure has been reported.

We compared the efficacy and long-term results of EVL performed in three treatments using a total of 16 O-rings at two different intervals, namely, biweekly (once every 2 weeks: the conventional interval) and bimonthly (once every 2 months). In all patients except two (both in the biweekly group), the esophageal varices were completely eradicated. Overall rates of both variceal recurrence and additional treatment were higher in the biweekly group than in the bimonthly group (P < 0.001).

EVL performed bimonthly in three treatment sessions for esophageal varices yielded better results than the same treatment performed biweekly. Treatment at the longer interval yielded a higher total eradication rate, lower recurrence rate, and lower rate of required additional treatment. Repeat treatment of EVL is useful; therefore, three treatment sessions should be considered as one course. Bimonthly EVL (three times in 4 months) might become a standard treatment for esophageal varices.

Keywords

Bimonthly EVL Endoscopic variceal ligation (EVL) Esophageal varices Repeat treatment 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Hiroshi Yoshida
    • 1
    Email author
  • Hiroshi Makino
    • 2
  • Tadashi Yokoyama
    • 2
  • Hiroshi Maruyama
    • 2
  • Atsushi Hirakata
    • 2
  • Junji Ueda
    • 2
  • Hideyuki Takata
    • 2
  • Yasuhiro Mamada
    • 1
  • Nobuhiko Taniai
    • 3
  • Eiji Uchida
    • 1
  1. 1.Department of SurgeryNippon Medical School HospitalTokyoJapan
  2. 2.Department of SurgeryNippon Medical School Tama Nagayama HospitalTokyoJapan
  3. 3.Department of SurgeryNippon Medical School Musashi Kosugi HospitalTokyoJapan

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