Endoscopic Variceal Banding
Introduction
Endoscopic band ligation (EBL) became the preferred technique for the endoscopic treatment of esophageal varices when it was proven in several randomized trials to be as effective as endoscopic variceal sclerotherapy but with fewer serious adverse events (1). EBL began as a single-shot device and has evolved into several commercially available multiband devices that are capable of firing as many as 10 bands in succession. This article reviews the technique we use for EBL of esophageal varices.
Indications for endoscopic band ligation
The indications for EBL of esophageal varices include (i) control of acute variceal bleeding, (ii) primary prophylaxis to prevent the first episode of variceal bleeding in high-risk patients, and (iii) secondary prophylaxis to prevent rebleeding following an initial episode of acute variceal bleeding (Table 1). In the setting of acute variceal bleeding, the clinical approach and EBL technique differ from those used for prophylaxis (elective EBL) and are therefore described separately.
