What is esophageal varicose vein ligation?

​Patients with cirrhosis of the liver, when the liver damage is severe enough, experience dilatation of the oesophageal venous network (varices) which may occasionally bleed, resulting in severe bleeding into the digestive tract. Esophageal variceal ligation is the recommended endoscopic procedure for the prevention and treatment of esophageal variceal bleeding in which elastic rings are placed over the varices, resulting in their disappearance.

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The procedure is performed in a hospital setting since it can have the complication of bleeding from varicose veins that will require hospital treatment. In many cases, the procedure to ligate the esophageal varices may need to be repeated until the varices have completely disappeared and patients will need to be on a surveillance program with endoscopy for early detection of recurrence and treatment

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What are the signs of esophageal varices?

​Every patient with liver cirrhosis needs to be on a surveillance programme to detect and treat oesophageal varices. Most commonly, medication is used for primary prevention of bleeding but when there are signs of increased risk of bleeding varices may need to be banded as well.

Esophageal variceal ligation is the method of choice for the treatment of variceal bleeding in hospitalized patients and for the secondary prevention of esophageal variceal bleeding after the first treatment session. In addition to the dressing, medication (beta-blockers) is used to prevent recurrence of bleeding.

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During the operation

​Your doctor will then perform a gastroscopy to check for varicose veins in the oesophagus. If necessary, he will proceed to treat the varicose veins by bandaging them, during which plastic rings will be placed on the base of the varicose veins with the help of suction. These plastic rings are usually detached from the oesophageal wall after about 10 days.

In some cases, the patient may need to be hospitalized after the varicose veins are bandaged for better monitoring of the patient and administration of drug therapy.

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After the operation

You should be monitored carefully for the next 10-15 days after the dressing treatment for possible complications

An adult will need to accompany you home after the operation. Do not drive or operate any machinery for the next 24 hours.

Are there any complications from esophageal varicose vein ligation?

​Sometimes it is possible to have complications from the procedure such as those of a simple gastroscopy. A common complication is failure to control bleeding which will require further in-hospital hospitalisation and other treatment. When the plastic rings fall off it is possible to have a recurrence of bleeding.