Beta
40881

Comparative study between argon plasma coagulation and endoscopic band ligation for treatment of bleeding from gastric antral vascular ectasia in cirrhotic patients

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Infectious Diseases & Endemic Hepato-Gastroenterology

Advisors

Marzouq, Hanan A., Ebrahim, Ebrahim M., Abdel-Bari, Muhammad S.

Authors

Aly, Aly Abdel-Rahim

Accessioned

2017-07-12 06:39:53

Available

2017-07-12 06:39:53

type

M.D. Thesis

Abstract

Background: Gastric antral vascular ectasia (GAVE) is characterized bymucosal and submucosal vascular ectasia causing recurrent GIhemorrhage. Treatment of GAVE with argon plasma coagulation (APC)requires multiple sessions for control of bleeding. Endoscopic bandligation (EBL) has become the standard treatment of varices.Additionally, EBL has been used for control of bleeding from other GIvascular lesions. In patients with GAVE and recurrent GI hemorrhage,EBL may offer an alternative to APC for treatment of large areas ofdiseased mucosa and submucosa.Objective: Our purpose was to evaluate the therapeutic effects of EBL asa new modality for the treatment of bleeding from GAVE in comparisonto the standard method which was APC.Patients & methods: This study was conducted on 40 adult cirrhoticpatients with overt or occult bleeding from GAVE, 20 of them weresubjected to APC and 20 of them were subjected to EBL.Results: EBL had a significantly higher rate of bleeding cessation (95%vs 65% p = 0.018), fewer treatment sessions required for cessation ofbleeding (2.25 vs 5.5 p= 0.001), a greater increase in Hb values (2.45 vs1.43 p= 0.052), a greater decrease in hospitalizations (-1.85 vs -0.55 p =0.046), a greater decrease in transfusion requirements (-5.4 vs -2.1 p <0.01) during the follow up period. No complications had been occurred inboth groups.Conclusion: Both APC and EBL are effective in managing GAVE.However, EBL proved to be superior to APC in improving post procedureoutcomes of cessation of bleeding, transfusion and hospitalization inpatients with GAVE. EBL also accomplishes these outcomes in fewerendoscopic sessions

Issued

1 Jan 2013

DOI

http://dx.doi.org/10.21473/iknito-space/34818

Details

Type

Thesis

Created At

28 Jan 2023