The Takase method of endoscopic injection sclerotherapy (EIS) obliterates esophagogastric varices and their associated blood supply. Obliteration of blood supply routes contributes to lower the recurrence of esophageal varices after EIS. In endoscopic injection sclerotherapy with simultaneous ligation (EISL), EIS is performed first followed by endoscopic variceal ligation (EVL). The suction of the injection site is maintained after EIS to facilitate EVL. Band ligation is performed at the site of injection. As the blood flow is blocked by ligation, EISL allows the sclerosant to remain at the site. It is less invasive and requires fewer sessions and less sclerosant. There is less chance of bleeding from the injection site as the variceal puncture is ligated. EISL is indicated for esophageal varices, especially for pipeline varices, cardiac varices which drain into esophageal varices, and/or special type of varices.
This is a preview of subscription content, log in to check access.
I thank Dr. Niranjan Sharma PhD, Mornington Health Centre, Dunedin, New Zealand, for helpful comments.
Takase Y, Ozaki A, Orii K, Nagoshi K, Okamura T, Iwasaki Y. Injection sclerotherapy of esophageal varices for patients undergoing emergency and elective surgery. Surgery. 1982;92:474–9.PubMedGoogle Scholar
Takase Y, Shibuya S, Chikamori F, Orii K, Iwasaki Y. Recurrence factors studied by percutaneous transhepatic portography before and after endoscopic sclerotherapy for esophageal varices. Hepatology. 1990;11:348–52.CrossRefGoogle Scholar
Stiegmann GV, Goff JS, Michaletz-Onody PA, Korula J, Lieberman D, Saeed ZA, et al. Endoscopic sclerotherapy as compared with endoscopic ligation for bleeding esophageal varices. N Engl J Med. 1992;326:1527–32.CrossRefGoogle Scholar
Nishikawa Y, Hosokawa Y, Doi T, Shima S, Miyoshi M, Ohnishi T, et al. Simultaneous combination of endoscopic sclerotherapy and endoscopic ligation for esophageal varices. Gastrointest Endosc. 1995;42:358–60.CrossRefGoogle Scholar
Nishikawa Y, Hosokawa Y, Doi T, Endo H, Tanimizu M, Hyodo I, et al. Evaluation of endoscopic injection sclerotherapy with and without simultaneous ligation for the treatment of esophageal varices. J Gastroenterol. 1999;34:159–62.CrossRefGoogle Scholar
Shigemitsu T, Yoshida T, Harada T, Takeo Y, Nakamura H, Okita K. Endoscopic injection sclerotherapy with ligation versus endoscopic injection sclerotherapy alone in the management of esophageal varices: a prospective randomized trial. Hepatogastroenterology. 2000;47:733–7.PubMedGoogle Scholar
Umehara M, Onda M, Tajiri T, Toba M, Yoshida H, Yamashita K. Sclerotherapy plus ligation versus ligation for the treatment of esophageal varices: a prospective randomized study. Gastrointestinal Endosc. 1999;50:7–12.CrossRefGoogle Scholar
Chikamori F, Kawashima T, Takase Y, Inoue A, Okamoto H, Kuniyoshi N, et al. Endoscopic therapy and interventional radiology for pipeline esophageal varices (in Japanese). Endosc Dig. 2010;22:1764–71.Google Scholar