ASSESSMENT OF HEPATIC, RENAL FUNCTIONS, AND PORTAL HEMODYNAMICS FOLLOWING ENDOSCOPIC VARICEAL LIGATION VERSUS ENDOSCOPIC INJECTION SCLEROTHERAPY

Abstract

Esophageal variceal haemorrhage is a life- threatening emergency with a mortality rate of 30-50%. In the last three decades there have been many advances in therapeutic modalities for control of bleeding, and prevention of variceal re-bleeding<207l.

Therapy for bleeding requires appropriate facilities. Endoscopic therapy using either variceal injection sclerotherapy"EIS" or band ligation "EVL" after adequate resuscitation is preferred as a first-line treatment<208l.

Many studies were applicated to compare the safety, efficacy of both techniques in esophageal variceal haemorrhage.However, the delayed effect of both therapeutic option is an important item for better evaluation.

Hence, the application of the present study to assess,compare the systemic effect following variceal sclerotherapy and rubber band ligation as well as their effect on portal hemodynamics .

The present study is carried out on 60 patients "39 males, 21 females" with active or recent esophageal variceal haemorrhage following post-hepatitic cirrhosis "hepatitis B surface antigen is positive in 13 patients. Anti HCV antibodies are positive in 50 patients, 3 patients are positive for combined infection". They are scheduled according to pugh's modification of child's classification into: 38 patients of class A, 14 patients of class B as well as 8 patients of class C.