Endoscopic Banding Ligation for Bleeding Esophageal Varices by using Hemorrhoid Rubber Band ; Personal Experience

Background : Endoscopic Banding Ligation (EBL) is now accepted to be the treatment of choice for bleeding esophageal varices,because it's more effective,easier and fewer complication than other treatments. Because the kit set for EBL is very expensive (1,000 Bht./l banding) and the set is single use.So we try to use hemorrhoid rubber band for reloading the useless kit set and found that hemorrhoid rubber band was effective to control bleeding and less expensive (8Bht/lbanding). Before we use hemorrhoid rubber to treat the patients,we have tested these rubbers and original rubbers physically including elasticity and the result are closely equal. Objective : To study result of reloaded Endoscopic Banding Ligation (EBL) use hemorrhoid rubber band in patients with bleeding esophageal varices at Surin Hospital from January 1999 - December 2001 Setting :   Department of Surgery, Surin Hospital Research Design :   Prospective descriptive study Method :   Bleeding varices patients treated with reloaded EBL were follow up monthly. Results :   In this study we report 43 patients with bleeding esophageal varices treated by EBL with reloaded hemorrhoid rubber band. During this study, 6/43 patients (13.5%) died of different causes, 5/43 patients (11.6%) rebled within 30 days without major complication, 5/43 (11.6%) had minor complications (fever,retrosternal chest pain,dysphagia and sore throat). Conclusion : We conclude that reloaded hemorrhoid rubber band is safe and effective enough for treating bleeding esophageal varices. We also introduce the easy technique to reload hemorrhoid rubber band to "SURIN HOSPITAL TECHNIQUE"