Endoscopic variceal ligation, or endoscopic band ligation, is a procedure that uses elastic bands to treat enlarged veins, or varices, in esophagus. These abnormal veins develop in the esophagus and have thin walls with high blood pressure running through them. If not treated, the veins may rupture and cause serious bleeding.
Variceal banding stops blood from leaking from varices, which significantly lowers the risk of serious health problems. This type of procedure involves the use of endoscopy to place bands around the affected veins. These bands cut off blood flow to these veins, which stops bleeding from occurring. Since variceal bleeding can occur more than once, some patients will need to have this procedure done again. In some cases, this banding procedure is combined with other treatments to help stop bleeding in the digestive tract.
Endoscopic therapy is the method most commonly used to treat immediate (acute) variceal bleeding. It also may be used to prevent recurrent episodes of variceal bleeding, which are common. The two forms of endoscopic therapy are:
Endoscopic therapy is usually used along with medicines such as beta-blockers and vasoconstrictors.
During variceal banding, an endoscope to place an elastic ring that looks like a rubber band around an enlarged vein. Banding the vein in this manner will cut off blood flow through the vein. It may be difficult to use this procedure while someone is actively bleeding, because the device used to place the bands obscures the doctor's vision.
Variceal banding has been shown to be as effective as sclerotherapy in treating episodes of bleeding.Variceal banding is often done several times to control the varices and prevent bleeding. For example, banding might be repeated every 2 to 4 weeks for 3 to 4 sessions. Your doctor will monitor (check) the varices every 3 to 12 months after that for the rest of your life.
During endoscopic sclerotherapy, a chemical called a sclerosant may be injected directly into an enlarged vein or into the wall of the esophagus next to the enlarged veins. The substance causes inflammation of the inside lining of the vein, which over time causes the vein to close off and scar. When the vein is closed off, blood cannot flow through it.Endoscopic sclerotherapy may be effective for stopping immediate (acute) bleeding caused by esophageal varices.Even if sclerotherapy is done at first, variceal banding is usually done later to prevent future bleeding. Both procedures work. But variceal banding has less chance of complication than sclerotherapy.
You will be taken into a recovery area for monitoring as your sedative wears off. For four hours after your procedure, you should only consume clear liquids. After four hours, you may eat soft foods for the remainder of the day. Some people may experience mild to moderate chest pain after variceal banding.
Endoscopic variceal ligation (EVL) is the endoscopic interventional procedure of choice for Bleeding Esophageal Varices. Advantagesinclude