Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2020; 12(10): 365-377
Published online Oct 16, 2020. doi: 10.4253/wjge.v12.i10.365
Published online Oct 16, 2020. doi: 10.4253/wjge.v12.i10.365
Defining the advantages and exposing the limitations of endoscopic variceal ligation in controlling acute bleeding and achieving complete variceal eradication
Jake Krige, Eduard Jonas, Urda Kotze, Christo Kloppers, Karan Gandhi, Hisham Allam, Marc Bernon, Sean Burmeister, Mashiko Setshedi, Departments of Surgery and Medicine, University of Cape Town Health Sciences Faculty, Cape Town 7925, South Africa
Jake Krige, Department of Surgery, University of Cape Town Health Sciences Faculty, Cape Town 7925, South Africa
Author contributions: Krige J, Jonas E and Kotze U devised the study concept and design; Krige J, Kotze U were involved in acquisition of data; Krige J, Jonas E, Kotze U, Kloppers C, Gandhi K, Allam H, Bernon M and Burmeister S analyzed and interpreted the data; Krige J, Jonas E and Kotze U drafted the manuscript; Krige J, Jonas E, Kotze U, Kloppers C, Gandhi K, Allam H, Bernon M, Burmeister S and Setshedi M critically revised the manuscript for important intellectual content; Krige J, Kotze U and Setshedi M carried out the statistical analysis; Krige J and Jonas E provided final approval of the article.
Institutional review board statement: This study was approved by the Human Research Ethics Committee University of Cape Town Health Sciences Faculty.
Conflict-of-interest statement: They authors declare they have no conflict-of-interest.
Data sharing statement: No additional data.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jake Krige, MBChB, MSc, PhD, FACS, FRCS (Ed), FCS (SA), Emeritus Professor, Department of Surgery, University of Cape Town Health Sciences Faculty, Anzio Road, Cape Town 7925, South Africa. jej.krige@uct.ac.za
Received: April 28, 2020
Peer-review started: April 28, 2020
First decision: May 24, 2020
Revised: June 29, 2020
Accepted: September 11, 2020
Article in press: September 11, 2020
Published online: October 16, 2020
Peer-review started: April 28, 2020
First decision: May 24, 2020
Revised: June 29, 2020
Accepted: September 11, 2020
Article in press: September 11, 2020
Published online: October 16, 2020
Core Tip
Core Tip: Control of acute bleeding is crucial in patients with portal hypertension and actively bleeding esophageal varices (BEV). The present study demonstrated that endoscopic variceal ligation (EVL) was highly effective in controlling acute variceal bleeding during the first endoscopic intervention in 95.7% of 140 patients with an overall 5-d failure to control bleeding of 7.1%. Although repeated EVL achieved complete variceal eradication in less than half of patients with BEV, of which 62% recurred, there was a significant reduction in subsequent rebleeding. EVL was effective and safe with a low complication rate in treating BEV.