Hemorrhage Due Status Post Rubber Band Ligation of Esophageal Varices - Appearance of the Mucosa

Sclerotherapy Versus Banding for Variceal Bleeding. Endoscopic sclerotherapy also reduces the rate of rebleeding, although overall mortality is not affected. The main disadvantage of endoscopic sclerotherapy is the variable incidence of local and systemic complications, with serious complications occurring in 10-20% of patients, leading to a 2-5% procedure-related mortality. Multiple studies have demonstrated that variceal ligation has a remarkably low complication rate. A number of studies have been completed to compare the efficacy and safety of endoscopic sclerotherapy versus endoscopic variceal ligation. These studies demonstrate that ligation is equally as effective as sclerotherapy in achieving control of acute variceal bleeding. On the basis of the results of a number of trials comparing sclerotherapy with band ligation, endoscopic variceal ligation has evolved to be the preferred first line modality for the endoscopic treatment of esophageal variceal bleeding.