Abstract
Falling factors of 91 clipping apparatus (Olympus Optical Co Ltd. ; HX-3L) used for endoscopic variceal ligation (EVL-c) were studied by multivariate analysis in 19 cirrhotic patients with esophageal varices admitted in our hospital between July, 1991 and August, 1992. The cummulative non-falling probabilities were 87.7%, 80.2%, 69.0%, and 36.3% at 2, 4, 6, and 8 weeks, respectively. Multivariate analysis of non-falling factors using Cox's regression proportional hazard model showed that previous endoscopic injection sclerother-apy (EIS) was statistically significant non-falling factor (p = 0.00147), while the other 8 factors (age, sex, indication of EVL-c, Child's classification, combination with EIS, var-iceal form and location, and diet after therapy) were not significant. The univariate analysis using generalized wilcoxon test revealed that this factor was also significant (p= 0.0150). Although food comes into contact with clipping apparatus in the esophagus directly, the diet factor was not significant. It was suggested that a clipping apparatus was easy to be fallen if esophageal ulcer was made up just on the clipping site, but the factor of combination with EIS was not significant. We conclude that previous EIS is the most significant non-falling factor of clipping apparatus used for EVL-c and one must be careful for early falling of them when treating patients of recurrent varices with EVL-c.
