Abstract

Endoscopic variceal band ligation requires the incertion of over tube. Since adopting EVL, we encountered pharyngeal trauma and complaints of severe pain during over tube insertion. So We compared the safety and efficacy of EVL according to the method of scope insertion, as over tube and free hand method. We studied 49 patients who require EVL due to grade 3 esophageal varices. The group l consist of 26 patients who undergone EVL without over tube and group 2 consist of 23 patients who undergone EVL with over tube. There were no differences in basal arterial oxygen saturation by pulse oxymeter, basal heart rate and EKG by EKG monitor, hemoglobin concentration, and Child class between 2 groups. The changes of arterial oxygen saturation and EKG were not different between 2 groups during EVL. And the symptom score and speed of single band ligation were similar in over tube and free hand method of EVL. The complication induced by scope insertion methods is minor pharyngeal trauma only in over tube group. We suggest that over tube method of EVL can be replaced by free hand method in patients who complain of severe pain during over tube insertion, and with anatomical abnormality of oropharynx and urgent cases in which require good vision.

• Keywords: Endoscopic variceal ligation , Over tube , Free hand