Endoscopic Treatment of Gastroesophageal Varices: Efficacy and Safety in Children

Purpose: Our purpose was to evaluate the efficacy and safety of endoscopic variceal band ligation (EVL) and Histoacryl injection for the treatment of gastroesophageal varices in children. Risk factors of rebleeding were analysed preliminarily. Methods: 15 children with esophageal varices and/or gastric varices who received EVL and/or Histoacryl injection were enrolled at our endoscopy center between October 2009 and March 2012. Demographic data, clinical characteristics and endoscopic data were registered and analysed as a Single-center prospective study. Results: The mean age was 9.5 +/- 3.3 years (2.5-14.3 years). The mean of clinical follow-up was 13.0 +/- 10.8 months (range 1-30 months). EVL and/or Histoacryl injection was successfully performed in all children. Immediate control of bleeding was achieved in all cases. The number of rubber bands placed in all patients ranged from 2 to 6. Early slippage of the rubber bands were not been found in the post-EVL rebleeding. Varices relapse with rebleeding was observed in 4 of 15 (26.7%) patients after a mean time of 14.8 +/- 6.5 weeks (5-24 weeks) follow-up. Patients with variceal rebleeding were retreated. Aggravated coagulation state, decreased platelets and ascites may be meaningful in predicting rebleeding. During follow-up, no fatal complication was observed in the patients. Conclusion: In children, the use of EVL and Histoacryl injection is safe and effective for the treatment of gastroesophageal varices. Effective measures for prevention and treatment of rebleeding should be adopted before and after operation.