Korean Journal of Gastrointestinal Endoscopy 1997;17(1): 1-7.
원저 : 식도 위장관 ; 식도정맥류 출혈시 내시경적 경화요법과 고무밴드 결찰요법의 치료 효과 ( Original Articles : Esophagus , Stomach & Intestine ; Comparison of Endoscopic Sclerotherapy & Band Ligation for the Treatment of Esophageal Variceal Bleeding )
정준모, 김성국, 김영탁, 권혁만, 금민수, 이창형, 권영오, 최용환 (Joon Mo Chung, Sung Kook Kim, Young Tak Kim, Hyek Man Kwen, Min Su Kum, Chang Hyung Lee, Young Oh Kwen and Yong Hwan Chio)
Abstract
Background/Aims: Endoscopic sclerotherapy is an accepted treatment for the patients with esogeal variceal bleeding, but endoscopic varicea1 band ligation, introduced by Stiegmann et al in 1986, is a new form of endoscopic treatment method, and may be safer. This study is performed to compare the effectiveness and safety of the two techniques. Methods: We compared endoscopic sclerotherapy and endoscopic ligation in 10~8 patients who had recently bled from esophageal varices. We assessed the hemostatic efficacy for bleeding varices, the number of sessions of treatments needed to eradicate varices, the incidence of complications, rebleeding rate and survival rate of the patients by two techniques. Results: Active bleeding was well controlled by sclerotherapy in all of six patients, and ligation in all of five patients by the initial treatment. The mean number of treatment sessions required to achieve eradication did not significantly differ between sclerotherapy and ligation(2.4+0.8 vs 1.8+ 1.0 sessions). Complications were less comman in ligation than sclerotherapy; chest discomfort(5.6% vs 29.6%), fever(3,7% vs 16.7%), esophageal ulcer(0% vs 5.6%), esophageal stricture(0% vs 3.7%). The rate of recurrent bleeding was significantly lower in the patients treated with ligation(p<0.05). The overall rate of survival was significantly higher in the patients treated with ligation(p<0.05), The days of hospitalization was significantly shorter in the patients treated with ligation than sclerotherapy(14.8+-7.0 vs 21.0+-9.7 days). Conclusions: The patients with esophageal variceal bleeding treated with endoscopic ligation have fewer treatment-related complications, lower rates of rebleeding and better survival rates. (Korean J Gastrointest Endosc 17: 1-7, 1997)
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