INTERET DE LA LIGATURE ENDOSCOPIQUE DES VARICES OESOPHAGIENNES DANS LA PREVENTION DES RECIDIVES HEMORRAGIQUES CHEZ LE CIRRHOTIQUE

Abstract

Objective - Ta evaluate the effectiveness and morbidity of endoscopic variceal ligation in secondary prevention of recurrence bleeding by ruptured esophageal varices at the cirrhotic in CHU Tlemcen. Materials and methods: Between January 2004, starting date of this study retro and forward-looking and June 2007 date point, patients having received at least a ligature were upheld. Resuits - Fifty-six cirrhosis patients, including 40 post-viral hepatitis B or C having least one ligature: 29 men and 27 women, average age 52.8 years, (10 Child-Pugh A, 36 B and 10 C), with Varicose stage Il (n = 24) and stage III (n = 32). The average decline was 21.07 months. The eradication of esophageal varices was obtained in 78.6% of our patients after an average of 2.7 meetings. At an average period of 18.3 months, reanastomosis was detected in 38.1% 0f patients. A recurrence 0f bleeding was found in 23% of patients. The size of varices (Grade III) and the score Child Pugh C are factors that are significantly predictive of reanastomosis in our study, however neither sex nor age seem to play a role. At least one complication was observed in 17% of our patients. The mortality rate was 14.3% unrelated to the technique. Conclusion: The endoscopic variceal ligation is an effective technique, with 10w morbidity and easy achievement. It appears as a method of choice in the secondary prophylaxis of recurrence esophageal varice bleeding in the cirrhotic. The interest of the association of a beta blocker observed in our series is ta a high light.