Endoscopic variceal ligation
Endoscopic Variceal Ligation
Endoscopic variceal ligation or endoscopic band ligation : Procedure that uses elastic bands to varices in esophagus. This procedure is done in patients with portal hypertension due to cirrhosis or EHPVO or Budd chiari syndrome Patients with portal hypertension generally have veins dilated in esophagus which can rupture and lead to blood vomiting or blood in stools.
Diagnosis:
Patient has to come empty stomach for 6 to 7hrs so after midnight he has to be empty stomach if procedure is planned in morning. If patient is on any medications then doctor will advise which medicine has to be stopped and which to be taken with small amount of water.
Description of the Procedure :
Patient will be lying in left lateral position during procedure. A mouthpiece will be placed. A Endoscope with attached band to the tip will be passed into the esophagus. Images will display on a monitor. The enlarged varix will be sucked with the help of suction and bands are released, Mostly 4 to 6 bands are appllied. The endo scope will be removed.
Post Procedure :
Post EVL/Banding patient is kept NBM for 2 hrs, liquid diet is started after 2hrs and soft diet after 6hrs for 2 days and then full diet. Patient will have difficulty while swallowing food in view of placing of bands in esophagus which will get better gradually. On discharge medicines are started to reduce portal pressure. An upper endoscopy should be repeated every 6 to 12 months depending on size of varix.
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