Abstract
Background: Endoscopic variceal ligation (EVL) is difficult in cases in which the rupture site of varices is hard to identify. We retrospectivery investigated the effect of an alternative treatment for patients whose rupture site was unable to identify.
Methods and Subjects: Subjects of the present study were 66 patients with active bleeding from ruptured varice who received treatment in our hospital from 2004 to 2010. They were divided into 2 groups : group A, a ligation group in which the site of rupture was successfully identified, and a group B, a “spiral ligation” group in which the site was not identified. The former underwent EVL, and the latter underwent “spiral ligation” in which ligation was started from the esophagogastric junction, and proceded spinally upward.
Results: Of 66 patients, 55 received EVL and 10 received “spiral ligation”. Sengstaken-Blackmore (S-B) double tube insention was required in 2 patients in the former group and in one in the latter group to identify the rupture site. There were no significant differences in patients background, hemostasis rates, rebleeding rates and survival rates between the two groups.
Conclusion: This study suggests that “spiral ligation” is a useful alternative to EVL in cases whose rupture site is difficult to identify. It is simple with a few complications, and has a high success rate.
