Evaluation of the effects of dense endoscopic ligation for bleeding esophageal varices

Objective To evaluate the short-term and long-term effects of dense endoscopic variceal ligation (DEVL) for bleeding esophageal varices. Methods Patients with acute or with a history of esophageal variceal bleeding underwent regular DEVLs with a 2-3 week interval between 2 sessions until their varices disappeared at the lower 5-6 cm part of the esophagus. Follow-up study and gastroscopy were performed at 3, 6 and 12 months after the final DEVL in all patients. The results at 3 months were classified as short-term effects and those after 6 months as long-term ones. Results 126 patients underwent DEVLs with 403 sessions and 3641 ligations; each patient was ligated with a mean of 3.2 sessions and at 28.9 points. The cure rate of acute variceal bleeding was 100.0%; short-term rate of variceal eradication was 94.4% and variceal rebleeding occurred in 3.9% patients. After a mean of 22.3 months follow-up period, the recurrence of esophageal varices was observed in 11.9% patients, but the variceal rebleeding rate was only 3.2% and no patients died from it. Conclusion DEVL was very useful and effective in both short-term and long-term variceal eradication and prevention of variceal rebleeding.