Predictive Factors of Esophageal Varices Band Ligation Failure

Aims Esophageal varices ligation (EVL) is the first line endoscopic treatment in acute bleeding, secondary and primary prophylaxis of variceal bleeding. Although effective in most case, failure of EVL can occur and expose to high morbidity and mortality. However risk factors of EVL failure are not well established. The aim of our study was to determine the prevalence and risk factors of EVL failure.

Methods We conducted a retrospective study including patients with portal hypertension undergoing EVL between 2012 and 2017. We excluded patients aged under 18 years and patients having been treated with sclerotherapy. EVL failure was defined as failure of hemostasis or failure achieving eradication.

Results In total, eighty-nine patients were included 44 female and 45 male. The mean age was 55,9 ± 14,17 years. Cirrhosis was the main cause of portal hypertension (94 %). Indication of EVL was acute variceal bleeding and secondary prophylaxis in most of the patients (88.7 %). Severity of cirrhosis was classified as Child-Pugh A in 38.2 % of cases, Child-Pugh B in 51 % and Child-Pugh C in 10.8 %. Failure of endoscopic treatment was observed in 10 patients (11.2 %). In univariate analysis, EVL failure was associated with the decompensation of the underlying cirrhosis (p = 0.027), Child-Pugh score (p = 0.03), MELD score (p = 0.003), MELD-Na score (p = 0.001). MELD-Na score was the only independent factor in multivariate analysis (p = 0,004; 95 % IC [0,688-0,931]).

Conclusions In patients undergoing EVL, risk factors of failure should be taken into account in order to timely consider another therapeutic strategy. In our study high Meld-Na score was an independent factor of EVL failure.

Citation: Ayari M, Zaimi Y, Bel Hadj Mabrouk E et al. eP45 PREDICTIVE FACTORS OF ESOPHAGEAL VARICES BAND LIGATION FAILURE. Endoscopy 2021; 53: S111.

Publikationsverlauf

Artikel online veröffentlicht:
19. März 2021