Esophageal variceal ligation in the primary and secondary prevention of variceal bleeding

Abstract

This article is devoted to experience of endoscopic ligation of varices in N.A. Semashko Republic Clinical Hospital. We analyzed the results of ligation in 28 patients treated since February 2013 to March 2016. Selected patients had diagnoses of liver cirrhosis, syndrome of portal hypertension of different origin, 10 (35.5 %) had the history of one or more episodes of bleeding from varicose veins of the esophagus. Endoscopic ligation was performed for patients with varices of grade 3-4 according to J. Paquet classification, grade 3 according to N. Soehendra, K. Binmoeller classification improving primary and secondary prevention of bleeding. The effectiveness of endoscopic ligation as a method of primary and secondary prevention of bleeding from the varices, with subsequent transfer to oral administration of non-selective β-adrenoblockers was evaluated. In the result of the study throughout the entire period of observation we indicated no episodes of esophageal bleeding and established a low rate of recurrence of varices. Those patients who, after the first endoscopic ligation session, followed the recommendations for taking beta-blockers, have a better prognosis and the outcome in relation to patients who have neglected the recommendations. During the first year of follow-up there was one fatal outcome - a man with VHC died as a result of hepatocellular insufficiency.