Procedures
Endoscopic Variceal Ligation (EVL)
- Endoscopic Variceal Ligation (EVL) is a procedure in which an enlarged vein or a varix (the plural is varices) in the esophagus is tied off or ligated by a rubber band delivered via an endoscope. It is also called rubber band ligation.
- Esophageal varices develop as a complication of a sustained increase in blood pressure in the liver (portal hypertension), most commonly found in cirrhosis. The major problem with Esophageal Varices is the risk of bleeding.
- EVL is used control or stop bleeding or to prevent re-bleeding. The success of the procedure is in the range of 90%. The procedure is performed as in regular EGD. An accompanying device is inserted into the endoscope channel which allows the delivery of ligating rubber bands to the engorged varix. Number of banding depends on the varices seen and may average 4-6.
- Complications associated with EVL include additional bleeding due to tearing additional varices, ulceration of the lining over the varices, perforation or tear of the esophagus and aspiration of blood or gastric juice into the lungs.Patient preparation for the procedure
Patient preparation for the procedure
Preparation for EVL is fasting for 4-6 hours similar to performing a regular esophagogastroduodenoscopy (EGD). An intravenous line is placed to deliver sedation or other medications.
Dr. Kunal Das
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