Short- and long-term results of endoscopic variceal ligation for esophageal varices compared with injection sclerotherapy.

We assessed the efficacy and safety of endoscopic therapy for esophageal varices in Japanese patients comparing the results of ligation therapy performed in 101 patients with those of sclerotherapy with paravariceal injection of polidocanol in 40 patients. Both therapies were effective in controlling active hemorrhages. Hemostasis rates at the first endoscopic session were 100% in both groups and rebleeding rates were 40.0% in the sclerotherapy and 29.6% in the ligation group. Variceal eradication was achieved equally in both groups in approximately 90% of the patients. However, the ligation achieved eradication more quickly in fewer endoscopic sessions than did the sclerotherapy (mean; 2.1 vs. 3.7 sessions, P < 0.01). Complications such as rebleeding and intramural hematomas were less common in the ligation group. These results indicate some advantages of the ligation over the sclerotherapy. A disadvantage of the ligation therapy is that recurrence occurs more quickly than in the sclerotherapy, although the difference was not statistically significant.