Background and Study Aims: Recent advances in endoscopic technology have led to the
development of multiple-banding devices which avoid the use of an overtube in endoscopic
variceal ligation. In the present study we prospectively examined the safety and efficacy
of one such device compared with the conventional single-band ligator.
Patients and Methods: A total of 45 patients undergoing band ligation were randomly
assigned to receive ligation using conventional techniques (n = 22), or multiband
ligation (n = 23).
Results: The use of the multiband device was associated with a significant reduction
in sedation requirements (midazolam 7.1 mg vs. 9.9 mg, P < 0,01, multiband vs. conventional, respectively), less discomfort (4 % vs. 23 %
severe discomfort, P < 0.05). The total time of the endoscopic session was reduced in the multiband group
(8 minutes 25 seconds vs. 12 minutes 21 seconds, P < 0.01), as was the time required for application of all the bands (2 minutes 22
seconds vs. 5 minutes 34 seconds, P < 0.001), and average time taken per individual band application (36 seconds vs.
1 minute 36 secs, P < 0.01). In three patients who underwent ligation using the conventional method,
the procedure was stopped because of trauma secondary to overtube application.
Conclusions: Multiband ligation is safer, quicker, and associated with less patient
discomfort and morbidity when compared with conventional ligation.
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P. M. Harrison, M.D.
Institute of Liver Studies King's College Hospital
Denmark Hill, London SE5 9RS
United Kingdom
Fax: Fax:+ 44-20-7346-3167
Email: E-mail:phillip.harrison@kcl.ac.uk
