Long-term Outcomes of Endoscopic Variceal Ligation to Prevent Rebleeding in Children with Esophageal Varices.
10.3346/jkms.2013.28.11.1657
- Author:
Ki Soo KANG
1
;
Hye Ran YANG
;
Jae Sung KO
;
Jeong Kee SEO
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. jkseo@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Ligation;
Child;
Esophageal and Gastric Varices
- MeSH:
Child;
Duodenum/surgery;
Endoscopy/*methods;
Esophageal and Gastric Varices/*surgery;
Esophagus/surgery;
Female;
Gastritis/surgery;
Gastrointestinal Hemorrhage/*surgery;
Humans;
Ligation;
Male;
Recurrence/prevention & control;
Retrospective Studies;
Treatment Outcome
- From:Journal of Korean Medical Science
2013;28(11):1657-1660
- CountryRepublic of Korea
- Language:English
-
Abstract:
After an episode of acute bleeding from esophageal varices, patients are at a high risk for recurrent bleeding and death. However, there are few reports regarding the long-term results of secondary prophylaxis using endoscopic variceal ligation (EVL) against variceal rebleeding in pediatrics. Thirty-seven, who were followed for over 3 yr post-eradication, were included in the study. The mean duration of follow up after esophageal variceal eradication was 6.4+/-1.9 yr. The mean time required to achieve the eradication of varices was 3.25 months. The mean number of sessions and O-bands needed to eradicate varices was 1.9+/-1.2 and 3.8+/-1.5, respectively. During the period before the first EVL treatment, 145 episodes of bleedings developed in 37 children. Over the 3 yr of follow-up after variceal eradication, only 4 episodes of rebleeding developed in 4 of 37 patients. The four rebleeding episodes consisted of an esophageal variceal bleed, a gastric variceal bleed, a duodenal ulcer bleed, and a bleed caused by hemorrhagic gastritis. There was no mortality during long-term follow up after variceal eradication. During long-term follow up after esophageal variceal eradication using solely EVL in children with esophageal variceal bleeds, rebleeding episodes and recurrence of esophageal varices were rare. EVL is a safe and highly effective method for the long-term prophylaxis of variceal rebleeding in children with portal hypertension.
