EFFECT OF BAND LIGATION ON PORTAL HYPERTENSIVE GASTROPATHY AND DEVELOPMENT OF FUNDAL VARICES
Abstract
Background: Use of endoscopic therapies for esophageal varices has resulted in increasedprevalence of fundal varices and severe portal hypertensive gastropathy. This study was meant to
compare the effect of band ligation and sclerotherapy on development of fundal varices and portal
hypertensive gastropathy. Methods: Patients with esophageal varices presenting in the endoscopy
unit of Shiakh Zayed Hospital, with at least one previous endoscopy were included. Patient'˜s past
record was reviewed for findings and type of treatment given for varices during first endoscopy,
number of endoscopies till date, number of esophageal varices band ligation (EVBL) or
sclerotherapy sessions. All patients underwent upper GI endoscopy and findings were recorded.
Type of treatment patient rendered during first endoscopy either EVBL or sclerotherapy was
correlated to the presence of fundal varices and severity of portal hypertensive gastropathy
observed on present endoscopy, using Chi square test (χ2). Results: Eighty one patients were
included. Mean age of patients was 48.70+ 12.63. Esophageal varices band ligation was carried
out during first endoscopy in 49 (60.5%) patients and sclerotherapy in 31 (38.2%) patients. On
fresh endoscopy, fundal varices were seen in 25 (30.8%) patients. Severe portal hypertensive
gastropathy was found in 26 (32.1%) and mild in 54 (66.7%) patients. Severity of portal
hypertensive gastropathy and presence of fundal varices in recent endoscopy was significantly
more in patients with EVBL in first endoscopy. Conclusion: Band ligation of esophageal varices
is associated with more frequent development of fundal varices and worsening of portal
hypertensive gastropathy compared to sclerotherapy.
Key Words: Baveno scoring, Esophageal varices band ligation, Portal hypertensive gastropathy,
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