Abstract
Endoscopic variceal ligation (EVL) was developed as an alternative to endoscopic variceal
sclerosis (ES) because of the high complication rate seen with ES. The new technique
involves placement of small elastic bands around the variceal channels in the distal
esophagus. The first 146 consecutive patients treated with EVL during the period from
August, 1986 to July, 1989 are reported. Portal hypertension was caused by alcoholic
liver disease in 93 of these patients. The average age of the patients was 53 years
and 66 % were males. All of the patients had recently bled from esophageal varices.
At the time of treatment, 23 % of the patients were actively bleeding. They were all
treated acutely with EVL and had repeated treatments with the long-term goal of variceal
eradication. The overall survival was 73 %. Varices were eradicated or reduced to
grade one in 78 % of the 125 patients who were followed for more than 30 days. Variceal
eradication required a mean of 5.5 sessions. Recurrent bleeding occurred in 44 % of
the total patient population. There were no major complications from EVL. It is concluded
from this non-randomized experience that EVL is an effective treatment for bleeding
esophageal varices and that it appears to be as effective as sclerotherapy with fewer
complications.
