Combination Treatment of Endoscopic Ligation and Sclerotherapy for Esophageal Varices

Abstract

To evaluate combined therapy of endoscopic ligation and sclerotherapy, we have treated 83 consecutive patients with large esophageal varices by the therapy. Seventy-eight of 83 patients were prophylactically treated. Endoscopic ligation was first repeated until esophageal varices were flattened and thereafter sclerotherapy was added to eradicate the varices. One point eight sessions of ligation and 2.4 sessions of sclerotherapy per a patient were performed and all varices were eradicated. No severe complication such as acute renal failure and esophageal perforation was experienced. The 5-yr cumulative rates of nonbleeding from esophageal varices and variceal recurrence were 92.5% and 54.4%, respectively. In prophylactic cases, we compared the combined therapy with sclerotherapy alone performed in our hospital previously. The sclerotherapy group had more complications during treatment than the combination group (7.8% vs. 0%, p <0.05). There was no significant difference in cumulative rates of nonbleeding from esophageal varices and variceal recurrence between the two groups. The combination therapy is effective and safe treatment for esophageal varices, and especially for poor risk patients, may be more useful than sclerotherapy alone.