Endoscopic Treatment of Esophageal Varices
Acute variceal hemorrhage is one of the most fatal complications of cirrhosis. About 30–50% of the patients with cirrhosis have esophageal varices at diagnosis, and about 10% of the patients with cirrhosis develop varices every year. Therefore, the most important examination in reducing the incidence and mortality of variceal hemorrhage is screening endoscopy for presence of varices, urgent endoscopic therapy for emergent active variceal bleeding, and prophylactic endoscopic treatment for prevention of variceal bleeding. Many guidelines and reviews suggest that endoscopy should be carried out within 12 h in the management of active variceal hemorrhage. The most effective endoscopic treatment for esophageal variceal hemorrhage is band ligation, so-called endoscopic variceal ligation (EVL). Endoscopic injectional sclerotherapy (EIS) has been replaced by EVL and should no longer be offered as standard of care in acute esophageal variceal hemorrhage. In this chapter, we discuss current endoscopic treatment of acute variceal hemorrhage and endoscopic prevention of variceal hemorrhage.
KeywordsEsophageal varices Hemorrhage Endoscopy Endoscopic variceal ligation Endoscopic injection sclerotherapy
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