Abstract
We routinely perform mucosa-fibrosing therapy in addition to endoscopic variceal ligation (EVL) with or without sclerotherapy. We have compared the effect of mucosa-fibrosing therapy with argon plasma coagulation performed in 15 patients (APC group) with that with paravariceal injection of 1% polidocanol (AS) performed in 34 patients (AS group). Number of treatment sessions to eradicate varices in APC group (2.2±0.5 in total and 1.1 ±0.3 for mucosal fibrosing) was significantly smaller than that of AS group (2.8±0.5 and 1.6±0.6, respectively, p<0.05). One and 2 year cumulative recurrence-free rate of APC group (93.3% and 84%) were not different with those of AS group (87.9% and 76.9%), respectively. Stricture of esophagus was observed in 3 patients of AS group. Incidence of other complications was not different between both groups. It is suggested that mucosa-fibrosing therapy with APC is superior to that with AS because it causes more uniform ulcers, and is less invasive and more cost effective with the efficacy comparable to that with AS.
