EFFECT OF BAND LIGATION ON PORTAL HYPERTENSIVE GASTROPATHY AND DEVELOPMENT OF FUNDAL VARICES
AbstractBackground: Use of endoscopic therapies for esophageal varices has resulted in increasedprevalence of fundal varices and severe portal hypertensive gastropathy. This study was meant tocompare the effect of band ligation and sclerotherapy on development of fundal varices and portalhypertensive gastropathy. Methods: Patients with esophageal varices presenting in the endoscopyunit of Shiakh Zayed Hospital, with at least one previous endoscopy were included. Patient‘s pastrecord was reviewed for findings and type of treatment given for varices during first endoscopy,number of endoscopies till date, number of esophageal varices band ligation (EVBL) orsclerotherapy sessions. All patients underwent upper GI endoscopy and findings were recorded.Type of treatment patient rendered during first endoscopy either EVBL or sclerotherapy wascorrelated to the presence of fundal varices and severity of portal hypertensive gastropathyobserved on present endoscopy, using Chi square test (χ2). Results: Eighty one patients wereincluded. Mean age of patients was 48.70+ 12.63. Esophageal varices band ligation was carriedout during first endoscopy in 49 (60.5%) patients and sclerotherapy in 31 (38.2%) patients. Onfresh endoscopy, fundal varices were seen in 25 (30.8%) patients. Severe portal hypertensivegastropathy was found in 26 (32.1%) and mild in 54 (66.7%) patients. Severity of portalhypertensive gastropathy and presence of fundal varices in recent endoscopy was significantlymore in patients with EVBL in first endoscopy. Conclusion: Band ligation of esophageal varicesis associated with more frequent development of fundal varices and worsening of portalhypertensive gastropathy compared to sclerotherapy.Key Words: Baveno scoring, Esophageal varices band ligation, Portal hypertensive gastropathy,
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