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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2002, Number 4

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An Med Asoc Med Hosp ABC 2002; 47 (4)

Impact of variceal band ligation on the prevalence of portal hypertensive gastropathy in patients with esophageal varices

Noble LA, Rodríguez VG, López AME, González-Angulo RA, Mora LG, Fournier MFJ, Roble I

Language: Spanish
References: 16
Page: 202-205
PDF size: 49.29 Kb.


ABSTRACT

Objective: To determine the impact of variceal ligation on the portal hypertensive gastropathy (PHG) in a six-month follow-up period. Background: Variceal obliteration by sclerotherapy has been reported to increase the frequency and severity of portal hypertensive gastropathy. Methods: We included 326 endoscopic studies performed in 86 patients under treatment with propranolol, in whom variceal ligation was performed for active variceal hemorrhage or as secondary profilaxis. Patients with previous sclerotherapy were excluded. Information about patient’s age, sex, degree of gastropathy, esophageal varices size, presence of gastric varices and presence of active bleeding was registered. The presence of gastropathy was determined before and after ligation (two weeks, one month, three months and six months after ligation). Results: We compared eighty-six endoscopies performed before ligation and 240 endoscopies performed after ligation. Before ligation, the prevalence of mild PHG was 47.67% and severe PHG was 17.44% [Global prevalence 65.11%]. After variceal ligation, mild PHG was 63.75% and severe PHG was 11.25% [Global 75%]. The impact of variceal ligation is more obvious for mild PHG. When a subgroup analysis was performed in the postligation group according with the follow-up stage, the mild PHG increased from 47.67% (before ligation) to 64. 10% at two weeks, 62.3% at one month, 70.8% at three months and 58.49% at six months. Conclusion: Endoscopic ligation of esophageal varices increased the presence of PHG in patients under pharmacological treatment with propranolol, although it did not appear to increase significantly its severity.


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