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Évaluation de l’efficacité de la ligature élastique endoscopique pour le traitement de l’hémorragie aiguë par rupture des varices œsophagiennes chez les patients cirrhotiques (CHU Hassan-II de Fès) entre 2001 et 2007

Evaluation of the efficacy of endoscopic variceal ligation for acute oesophageal variceal bleeding in cirrhotic patients (Hassan-II University Hospital, Fez) between 2001 and 2007

  • Cas Clinique / Clinical Case
  • Published:
Journal Africain d'Hépato-Gastroentérologie

Résumé

Introduction et but du travail

La ligature endoscopique des varices est largement retenue comme le traitement optimal des varices œsophagiennes hémorragiques. Notre objectif est d’évaluer l’efficacité de la technique de la ligature endoscopique pour le traitement de l’hémorragie par rupture des varices œsophagiennes chez les patients cirrhotiques.

Matériel et méthodes

À travers une étude rétrospective, étalée sur 66 mois (décembre 2001–juillet 2007), tous les patients cirrhotiques présentant une hémorragie digestive par rupture de varices œsophagiennes et ayant bénéficié d’une ligature élastique à but hémostatique ont été inclus dans l’étude. On a étudié les taux d’hémostase, de récidive hémorragique, de complications et de mortalité.

Résultats

Cent quatre-vingt-deux patients ont été inclus dans l’étude, et 211 ligatures hémostatiques ont été réalisées. L’hémostase primaire a été obtenue dans 96,7 % des cas, un taux d’échec d’hémostase de 3,3 %, un taux de récidive hémorragique précoce de 3,2 % et tardif de 11 %, le taux de complications mineures a été de 25,4 %, le taux d’ulcères œsophagiens de 14,9 %, alors que le taux de mortalité par hémorragie a été de 12 %.

Conclusion

La ligature des varices œsophagiennes, pour le traitement de l’hémorragie aiguë par rupture œsophagienne, est une technique d’hémostase efficace avec un faible taux de récidives et de complications.

Abstract

Background and aim

Endoscopic variceal ligation is widely accepted as the optimum treatment for oesophageal variceal haemorrhage. Our aim is to evaluate the efficacy of endoscopic variceal ligation in the management of oesophageal variceal bleeding in cirrhotic patients.

Patients and methods

Via a retrospective study over 66 months (December 2001–July 2007) of all cirrhotic patients with oesophageal bleeding treated by endoscopic ligature, we studied the rate of haemostasis, relapse, complications and mortality.

Results

One hundred eighty-two patients were included and 211 haemostatic variceal ligations were performed. Primary haemostasis was obtained in 96.7% of cases, haemostasis failed in 3.3% of cases, early rebleeding occurred in 3.2% of cases and late rebleeding in 11%, the rate of minor complications was 25.4%, the rate of oesophageal ulcers was 14.9%, while themortality rate by haemorrhage was 12%.

Conclusion

Variceal banding ligation for the treatment of variceal bleeding is an effective haemostatic technique with low rates of rebleeding and complications.

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Authors and Affiliations

  1. BP 1731, 30003, Atlas, Fès, Maroc

    D. -A. Benajah, M. Lahbabi, R. Zamharir, N. Lahmidani, N. -E. Aqodad, M. El Abkari & A. Ibrahimi

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  1. D. -A. Benajah
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  2. M. Lahbabi
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  3. R. Zamharir
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  4. N. Lahmidani
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  5. N. -E. Aqodad
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  6. M. El Abkari
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  7. A. Ibrahimi
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Correspondence to D. -A. Benajah.

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Benajah, D.A., Lahbabi, M., Zamharir, R. et al. Évaluation de l’efficacité de la ligature élastique endoscopique pour le traitement de l’hémorragie aiguë par rupture des varices œsophagiennes chez les patients cirrhotiques (CHU Hassan-II de Fès) entre 2001 et 2007. J Afr Hepato Gastroenterol 3, 41–45 (2009). https://doi.org/10.1007/s12157-009-0073-1

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