Endoscopic treatment of esophageal varices in advanced liver disease patients: band ligation versus cyanoacrylate injection

Endoscopic treatment of esophageal varices in advanced liver disease patients: band ligation versus cyanoacrylate injection

Author Martins Santos, Marcus Melo Autor UNIFESP Google Scholar
Lenz Tolentino, Luciano Henrique Autor UNIFESP Google Scholar
Rodrigues, Rodrigo Azevedo Autor UNIFESP Google Scholar
Nakao, Frank Shigueo Autor UNIFESP Google Scholar
Silveira Rohr, Maria Rachel da Autor UNIFESP Google Scholar
Paulo, Gustavo Andrade de Autor UNIFESP Google Scholar
Kondo, Mario Autor UNIFESP Google Scholar
Ferrari, Angelo Paulo Autor UNIFESP Google Scholar
Della Libera, Ermelindo Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background the results of variceal band ligation (VBL) in patients with advanced liver disease are unknown. Cyanoacrylate injection (CI) might have a better outcome than VBL in the treatment of esophageal varices (EV) in these patients.Aim To compare VBL and CI in the treatment of EV in patients with advanced liver disease.Patients and methods Thirty-eight patients with medium or large EV and Child-Pugh index of at least eight were randomized into two groups: VBL (n = 20) and CI (n = 18). the patients were followed-up for at least 6 months after the end of treatment. Main outcomes were eradication, bleeding, mortality, complication, and recurrence rates.Results Variceal eradication rates were similar in the VBL and CI groups (90 vs. 72%, P = 0.39). Mean number of sessions until eradication was 3.17 and 3, respectively. Bleeding episodes until eradication were equally observed in both groups (P = 0.17). Mortality (55 vs. 56%, P = 0.52) and major complication rates (5 and 17%, P = 0.32) were similar. Chest pain with dysphagia was more frequent in the CI group (55.6 vs. 10%, P = 0.004). A higher risk of variceal recurrence was observed in the CI group (33 vs. 57%, P = 0.04).Conclusion No significant differences between the VBL and CI groups were observed in the treatment of EV in patients with advanced liver disease regarding mortality, variceal eradication, and major complications rates. However, minor complications and variceal recurrence were significantly more common in the CI group. in addition, there was a clear trend toward more bleeding episodes in patients included in the CI group. Eur J Gastroenterol Hepatol 23:60-65 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
Keywords band ligation
cyanoacrylate
esophageal varices
liver cirrhosis
portal hypertension
Language English
Date 2011-01-01
Published in European Journal of Gastroenterology & Hepatology. Philadelphia: Lippincott Williams & Wilkins, v. 23, n. 1, p. 60-65, 2011.
ISSN 0954-691X (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 60-65
Origin http://dx.doi.org/10.1097/MEG.0b013e3283415986
Access rights Closed access
Type Article
Web of Science ID WOS:000285085400009
URI http://repositorio.unifesp.br/handle/11600/33316

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