ENDOSCOPIC INJECTION SCLEROTHERAPY WITH SIMULTANEOUS LIGATION (EISL) FOR THE TREATMENT OF ESOPHAGOGASTRIC VARICES

Abstract

The Takase method of endoscopic injection sclerotherapy (EIS) obliterates the esophagogastric varices and their associated blood supply. Obliteration of blood supply routes reduces the recurrence rate of esophageal varices after EIS.　In endoscopic injection sclerotherapy with simultaneous ligation (EISL), EIS is performed first followed by endoscopic variceal ligation (EVL). Suction of the injection site is maintained after EIS to facilitate EVL. Band ligation is performed at the site of injection. As the blood flow is blocked by ligation, EISL allows the sclerosant to remain at the site. It is less invasive and requires fewer sessions and less sclerosant than the regular EIS procedure. There is less chance of bleeding from the injection site as the variceal puncture site is ligated. EISL is indicated for esophageal varices, especially pipe line varices, cardiac varices that drain to esophageal varices, and special types of varices.