Role of stage endoscopic variceal band ligation in treatment of children with portal hypertension

Abstract

The aim: To evaluate the efficacy of endoscopic variceal band ligation (EVL) after the first esophageal EVL session in children with PH according to endoscopic data. Materials and methods: EVL was performed to 39 patients with PH for the purpose of variceal bleeding primary and secondary prophylaxis. Results:Esophageal varices grade decrease was observed in 22 (56.41%) children. Cases of early rebleeding (within 14 days after EVL) were not registered. Eradication of varices was successful in 11 (28.2%) of patients. In 1 (2.56%) case the complication (bleeding) occurred while banding procedure. 1 (2.56%) patients had bleeding from gastric varices prior to a control endoscopy. Portal gastropathy grade changes were observed in 17 (43.59%) patients. Conclusions: EVL is a safe and effective method of esophageal varices bleeding prophylaxis. This method allows control the esophageal varices grade at different phases of PH treatment in children. Even one EVL session can decrease the grade of esophageal varices (р<0.001). The EVL effect on the severity of portal gastropathy (p=0.02) and on the red marks presence (p=0.005) was also determined. EVL reduced the risk of variceal rebleeding (р=0.05, RR=0.05 (95%CI 0.01-0.32)).