RISK FACTORS AND OUTCOMES ASSOCIATED WITH ENDOSCOPIC VARICEAL BAND LIGATION INDUCED ULCERS

Aims The aim of this retrospective study was to highlight the risk factors and outcomes associated with endoscopic variceal band ligation (EVBL) induced ulcers.

Methods This retrospective study was performed in our institute; collecting data between 2015 and 2019. Patient demographics, serological results, endoscopic reports and medical notes were catalogued. Management of patients with EVBL induced ulcers and outcomes were recorded. Data was analysed with SPSS 26.

Results A total of 152 sessions of EVBL were performed on 92 patients. The mean Model of End-Stage Liver Disease (MELD) was 14.54. 11 cases (7.7%) of post EVBL ulceration were reported in 10 patients; with 2 of these cases proving fatal. Univariate analysis revealed that a Child Pugh Turcotte (CPT) score of C, MELD score of greater than 15, alcoholic liver disease (ALD) and the absence of non-selective beta blockers (NSBB) in their drug regimen were independent risk factors for developing EVBL ulceration. The OR was 16.25 (CI 1.4–183, p = 0.014) for CPT score of C, 7.3 (CI 1.1–48.2, p = 0.019) for MELD score greater than 15 and 5.5 (CI 1.8–16.6, p = 0.026) if patients were not taking a NSBB.

Conclusions EVBL ulceration is a rare and potentially fatal complication. Our institute demonstrated a higher than globally reported EVBL-induced ulcer rate with an incidence of 7.7%. This was associated with a mortality rate of 18%. The incidence of EVBL ulceration was lower in patients taking a non-selective beta blocker. We observed a higher ulceration rate in patients with ALD cirrhosis, a CPT score of C and in patient’s with a MELD score greater than 15.