Korean Journal of Gastrointestinal Endoscopy 1996;16(5): 707-714.
원저 : 식도 위장관 ; 식도정맥류에 대한 내시경적 결찰요법의 치료효과 및 장기 추적관찰 ( Original Articles : Esophagus , Stomach & Intestine ; Efficacy and Longterm Follow-up of Endoscopic Variceal Ligation on Esophageal Varix Bleeding )
윤용범, 송인성, 김정룡, 이효석, 윤정환, 정현채, 김용태, 이동호, 이국래, 이한주, 정운태, 김재규 (Yong Bum Yoon, In Sung Song, Chung Yong Kim, Hyo Suk Lee, Jung Hwan Yoon, Hyun Chae Chung, Yong Tae Kim, Dong Ho Lee, Kook Lae Lee, Han Joo Lee, Woon Tae Chung and Jae Gyu Kim)
Abstract
Hemorrhage from esophageal varices is a catastrophic complication of portal hypertension. Endoscopic variceal ligation(EVL) is a newly developed technique that may replace Endoscopic injection sclerotherapy(EIS). But there are a few reports of longterm follow-up of EVL in Korea. We analysed 42 patients to evaluate longterm effect of EVL for esophageal varices. Total 689 variceal ligations were performed during 117 separate EVL sessions. Control rate of acute bleeding was 90.5%(38 of 42 patients). Four patients who were failed on control of acute bleeding were taken EIS with successful bleeding control. The eradication rate of esophageal varix was 76.2%(32 of 42 patients), the mean session for eradication of varix was 3,0(2-6), the number of bands per person was 16.0(5-41), and the number of bands per session was 6.0(4-11). Rebleeding after initiation of EVL occured in 1l of 42 patient(26,2%). 81.8% of rebleeding occurred 6 months later after EVL was done. The mortality rate and survival rate after varix eradication during follow-up period(after 6-45 months, mean: 15.5 months) was each 14.3%(6/42) and 85.7%(36/ 42). The causes of death were hepatic failure (3/6), esophageal variceal bleeding(2/ 6) and hepatic encephalopathy(l/6). After EVL, the~re were no serious treatment-re lated complications: except mild complications: mild chest pain in 5 patient(12.0%), mild substernal pain in 7 patients(16.6%). These results suggest that EVL is a safe and effective method for treatment of variceal bleeding control and eradication of esophageal varices with least serious complication. But regular periodic examination(interval of 4-6 months) and repeat EVL after eradication of varices should be required becuse of recurrence of varix and rebleeding. (Korean J Gaatrointest Endosc 16: 707~714, 1996)
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