Endoscopic variceal ligation has emerged as a superior alternative to endoscop ic injection sclerotherapy, however, the “single-shot" mechanism of the genera lly used Stiegman-Goff ligator made the procedure ted...Endoscopic variceal ligation has emerged as a superior alternative to endoscop ic injection sclerotherapy, however, the “single-shot" mechanism of the genera lly used Stiegman-Goff ligator made the procedure tedious and time-consuming a nd required overtube placement, associated with discomfort and potentially life -threatening complications. In this study we describe our experience with the S aeed Six-Shooter (multiple-ligation device). Fifty con- secutive patients with variceal bleeding were prospectively studied. After ini tial endoscopic ligation, subsequent sessions were every 2 weeks. Study outcomes were: the ability to control active bleeding, the frequencies of rebleeding, th e number of treatment sessions and time required for irradication, the percentag e eradication of varices, complications, and mortality. Active bleeding was cont rolled in all eight (100%) patients. Four (8%) patients rebled, three from eso phageal varices, and one from portal hypertensive gastropathy. Esophageal varice s were eradicated in 47 (94%) patients (3.1 ±1.3 sessions). Time needed till e radication was 6.2 ±1.9 weeks. Chest pain was reported in two (4%), low, grade pyrexia in two (4%), and pneumonia in one (2%) patient. There were three deat hs, none due to exsanguination.The Six-Shooter is a safe and efficient device f or the endoscopic ligation of esophageal varices which has overcome the limitati ons of the single-shot ligator: (1) Visualization is better (the endoscopic “t unnel vision" and internal light reflection from the stainless-steel banding cy linder of the single-shot device are avoided); and (2) the use of an overtube i s no longer necessary and serious complications can be avoided.展开更多
文摘Endoscopic variceal ligation has emerged as a superior alternative to endoscop ic injection sclerotherapy, however, the “single-shot" mechanism of the genera lly used Stiegman-Goff ligator made the procedure tedious and time-consuming a nd required overtube placement, associated with discomfort and potentially life -threatening complications. In this study we describe our experience with the S aeed Six-Shooter (multiple-ligation device). Fifty con- secutive patients with variceal bleeding were prospectively studied. After ini tial endoscopic ligation, subsequent sessions were every 2 weeks. Study outcomes were: the ability to control active bleeding, the frequencies of rebleeding, th e number of treatment sessions and time required for irradication, the percentag e eradication of varices, complications, and mortality. Active bleeding was cont rolled in all eight (100%) patients. Four (8%) patients rebled, three from eso phageal varices, and one from portal hypertensive gastropathy. Esophageal varice s were eradicated in 47 (94%) patients (3.1 ±1.3 sessions). Time needed till e radication was 6.2 ±1.9 weeks. Chest pain was reported in two (4%), low, grade pyrexia in two (4%), and pneumonia in one (2%) patient. There were three deat hs, none due to exsanguination.The Six-Shooter is a safe and efficient device f or the endoscopic ligation of esophageal varices which has overcome the limitati ons of the single-shot ligator: (1) Visualization is better (the endoscopic “t unnel vision" and internal light reflection from the stainless-steel banding cy linder of the single-shot device are avoided); and (2) the use of an overtube i s no longer necessary and serious complications can be avoided.
