Endoscopic Treatment of Esophageal Varices: Simultaneous Combination of Endoscopic Injection Sclerotherapy and Endoscopic Variceal Ligation for Prevention of Recurrence

  • Fumio Chikamori


The Takase method of endoscopic injection sclerotherapy (EIS) obliterates esophagogastric varices and their associated blood supply. Obliteration of blood supply routes contributes to lower the recurrence of esophageal varices after EIS. In endoscopic injection sclerotherapy with simultaneous ligation (EISL), EIS is performed first followed by endoscopic variceal ligation (EVL). The suction of the injection site is maintained after EIS to facilitate EVL. Band ligation is performed at the site of injection. As the blood flow is blocked by ligation, EISL allows the sclerosant to remain at the site. It is less invasive and requires fewer sessions and less sclerosant. There is less chance of bleeding from the injection site as the variceal puncture is ligated. EISL is indicated for esophageal varices, especially for pipeline varices, cardiac varices which drain into esophageal varices, and/or special type of varices.


Endoscopic injection sclerotherapy with simultaneous ligation Esophagogastric varices Endoscopic injection sclerotherapy Endoscopic variceal ligation 



I thank Dr. Niranjan Sharma PhD, Mornington Health Centre, Dunedin, New Zealand, for helpful comments.


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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Fumio Chikamori
    • 1
  1. 1.Department of SurgeryTano HospitalKochiJapan

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