급성 식도정맥출혈에 대한 내시경적 경화요법과 내시경적 정맥류 결찰요법의 비교

Objectives: Endoscopic injection sclerotherapy (EIS) is currently the most widely practiced method for treating and eradicating bleeding esophageal varices in repeated sessions, but may be associated with some undesirable local and systemic complications. Endoscopic variceal ligation (EVL), which consists of mechanical ligation and thrombosis of varices using elastic "0"-rings, has been recently developed as a non-operative alternative to EIS. Methods: To evaluate the safety and efficacy of EVL for treatment of the acute bleeding esophageal varices, we compared EVL and EIS in 89 patients who had recently bled from esophageal varices. 43 patients were treated with EVL, and 46 with EIS. We assesed the hemostatic efficacy for actively bleeding varices, the recurrences of bleeding, the ablility for eradication of varices, the number and duration of treatments needed to eradicate varices, and the incidence of complications. Results: Initial hemostatic efficacy of EVL for actively bleeding varices did not differ to EIS (90% VS 90.9%). Incidences of rebleeding showed no statistical difference between EVL and EIS (18.6% vs 23.9%). Abilities for eradication of varices showd 83.7% (36 of 43 patients) in EVL and 82.6Fp (83 of 46 patients) in EIS. The number of treatments required to eradicate varices did not differ between EVL and EIS (4.2 vs 3.8 sessions), but EVL achieved variceal eradication more slowly than EIS (44,6 vs 20.8 days) (p