식도정맥류 출혈의 경화요법의 대치치료로써 내시경적 정맥류 결찰요법 = Endoscopie Variceal Ligation As an Alternative Treatment to Sclerotherapy for Esophageal Varices

다국어 초록 (Multilingual Abstract)

Currently, endoscopic injection sclerotherapy(EIS) is the mast widely used method for treating and eradicating acutely bleeding esophageal vari4~es in repeated sessions, but may be assaciated with some undesirable local and systemic cornplicatians. Endoscopic variceal ligation (EVL), a newly developed method to manage esophageal variceal bleeding alternating EIS, induces mechanical ligation and strangulation of varices by using elastic $quot;O$quot; rings.
This study assessed initial control rate of active variceal bleeding, ineidence of rebleeding, changes in grade of varices, survival rate, and complications associated with EVL.
Over a 15 months period, EVL was performed on 30 consecutive patients who had visited Taegu Catholic University Hospital by recent esophaigeal variceal bleeding or by actively bleeding varices. Total of 316 varix ligations were performed during 85 separated EVL sessions. Active bleeding varices were initially controlled in all seven(100%)patients. There were a 30% incidence of recurrent bleeding. By a mean of 3.4 times of EVL sessions, variceal eradication or reduction of size to grade I was achieved in thirteen patients. No major complications (perforation, stricture, deep ulceration) were noted and there were no treatment failures or exacerbations. Seven(23%) patients died, two from hepatic failure, one from rebleeding with refusal for repeated ligation, one from hepatic coma, two from hepatorenal syndrome, one from other cause(pancreatic cancer).
These results suggest that EVL can be used effectively to control active variceal bleeding, prevent rebleeding and eradicate varices with repeated ligations. We conclude that EVL is a safe and effective alternative treatment to sclerotherapy for esophageal varices.