Endoscopic band ligation and esophageal stents for acute variceal bleeding

Abstract

Patients with portal hypertension and esophageal varices are at risk of bleeding due to a progressive increase in portal pressure that may rupture the variceal wall. Appropriate treatment with initial general measures, such as resuscitation, a restrictive transfusion policy, antibiotic prophylaxis, pharmacologic therapy with vasoconstrictors, and endoscopic therapy with endoscopic band ligation are mandatory. However, 10% to 15% of patients fail initial endoscopic therapy and thus rescue therapies are needed. This article reviews the current endoscopic strategies with band ligation and esophageal stents for patients with acute variceal bleeding.

Keywords: Acute variceal bleeding; Cirrhosis; Endoscopic band ligation; Esophageal stents; Esophageal varices; Gastrointestinal bleeding; Portal hypertension; TIPS.