Background : Bleeding gastric va-rices is a highly fatal condition in cir-rhotic patients with portal hyperten­sion. The role of endoscopy in its management is still controversial. However both sclerotherapy and band ligation have been proven to be effec­tive in management of bleeding gas­tric varices. This study was performed to describe the combined use of band ligation plus histoacryl injection for the management of gastric varices.
Methods : Combined technique, band ligation plus histoacryl injection, was performed in 42 patients with gastric varices: 8 patients had type 1 gastroesophageal varices, 20 had type2,12 had isolated gastric varices typel and 2 had isolated gastric varic­es type 2. The etiology of portal hypertension was shistosomiasis in 15, post-hepatitic cirrhosis in 5 and mixed cirrhosis in 22 patients. The Child-Pugh classification was grade A in 10, B in 22, and C in 10 cases. Active variceal bleeding was present in all patients.
Results : Combined band ligation and histoacryl injection arrested acute bleeding in 37 patients (88.1%). Re­current bleeding occurred in 7 (16.6%) . Variceal obliteration was achieved in 35 patients ( 83.4%) at 4-6 months. The number of sessions needed for obliteration of varices was significantly less in patients with iso­lated gastric varices typel, when com­pared with those with typel and type2 gastroesophageal varices. Eight pa­tients died (19%), 4 due to recurrent bleeding,