RESUMO
Patients who have bled from esophageal varices remain at risk for rebleeding. There is interest in methods that would enable rapid control of active bleeding and eradication of esophageal varices. This study included two groups of patients with similar clinical and endoscopic characteristics. One group [28 patients] received endoscopic variceal ligation [EVL] and the second group [22 patients] received endoscopic injection sclerotherapy [EIS]. We compared both methods in terms of efficacy in controlling acute variceal bleeding, associated complications, eradication of varices, recurrence of varices during follow-up, and changes in portal vein blood flow after variceal eradication. Both EVL and EIS were comparable in control of active variceal bleeding [78.6% Vs 81.8%; p= 0.776] and eradication of varices [82.1% Vs 86.4%; p = 0.686]. Rebleeding was more probable to occur with ETS than EVL [7.1% Vs 27.3%; p = 0.054]. ElS was associated with more complications [54.5% Vs 14.3%, p = 0.002]. EVL required less number of endoscopic sessions to eradicate varices [3.82 +/- 0.98 Vs 4.86 +/- 1.36, p = 0.004] but was associated with more recurrence of varices during follow-up period of 8-12 months [35.7% Vs 9.1%], P = 0.029]. The changes in portal vein blood flow were transient after eradication of varices by both procedures. We conclude that while EVL and ElS are equally effective in controlling acute variceal bleeding and eradication of varices, ligation treatment shows greater advantages in the short-term follow up regarding the number of endoscopic sessions required to eradicate varices and the incidence of comp1ications, but is associated with more frequent recurrence of varices in the longer term, These two aspects should be considered for evaluation in the cost/benefits ratio arid quality of life analysis All patients should have frequent endoscopic evaluations [every three or four months] throughout the first year of follow-up