Ricerc@Sapienza

Background and aim: Esophageal varices are among the most serious
consequences of portal hypertension, the rate of bleeding per
year reaches 15% and the rate of mortality reaches 30%. The gold
standard for their treatment consists of endoscopic band ligation
(EBL), whether or not associated with non-selective beta-blockers.
The aims of the study were to:
1. Highlight the basal characteristics that allow the distinction of
patients who achieve the eradication from those whose in whom
treatment fails;
2. Highlight the basal characteristics that allow the distinction
of patients who need only one session of EBL to achieve the
eradication from those who need two or more sessions;
3. Identify the factors that can predict the last operational endoscopy
before the eradication.
Material and methods: This descriptive observational study was
carried out in the Department of Gastroenterology and Hepatology
of Policlinico Umberto I from March 2016 to May 2017. Fifty-five
patients with significant portal hypertension were enrolled and
treated with EBL for primary or secondary prophylaxis at the Endoscopic
Unit, Department of Surgical Sciences. At hospitalizationthey underwent EBL and they were subsequently re-endoscope at
one-month interval until the eradication of varices was achieved.
Results: Patients requiring a single endoscopic session to eradicate
varices showed significantly smaller varices (p=0.019), less number
of bands (p=0.04), absence of diabetes (p=0.01), and better renal
function (p Patients in whom endoscopic therapy failed were characterized by
the presence of ascites (p=0.01), longer varices (p=0.03), diabetes
(p whom EBL obtained varices eradication.
Finally, the EBL session that describes short varices (with a proximal
margin >30 cm, p=0.01) and needs less than 3 bands (p=0.01)
is more likely to be the last before the eradication (Table 1).
Multivariate analysis did not select significant independent factors.
Conclusions: Our study has highlighted factors that may predict the
success and the number of sessions of EBL treatment for esophageal
varices. Data needs to be verified in a larger number of patients.