Association of Endoscopic Esophageal Variceal Ligation with Duodenal Ulcer

J Coll Physicians Surg Pak. 2016 Apr;26(4):267-71.

Abstract

Objective: To determine the frequency of duodenal ulcer (DU), as well as other clinical characteristics occurring after endoscopic variceal ligation (EVL) of the esophagus.

Study design: Descriptive study.

Place and duration of study: The First Affiliated Hospital of Fujian Medical University, Fuzhou, China, from April 2012 to April 2013.

Methodology: A total of 47 patients with esophageal varices (EVr) who had also undergone EVL and gastroscopic follow-up within 3 months of the procedure was retrospectively analyzed. The status of Helicobacter pylori(Hp) infection, Child-Pugh classification, and the grades of portal hypertensive gastropathy (PHG) were collected. Sixty EVr patients without EVL treatment, but with clinical data available, served as the control group.

Results: The frequency of DU in the EVL group (29.8%, 14/47) was higher than the control group (6.7%, 4/60) (p=0.02). Hp infection rate in EVLgroup was 19.15% (9/47), while in control group was 21.67% (13/60) (p=0.813). Hp positive rate (12.5%, 1/8) in patients exhibited new DUs after EVL was comparable to the patients without DU in the EVL group (12.1%, 4/33) (p=1.00). Patients with DU after EVL received 18.79 ±8.48 of ligating bands, while in those who did not exhibit DUs received 13.85 ±6.47 (z = -2.042, p = 0.041). Logistic regression analysis showed that the occurrence of DU was not associated with age, gender, Child-Pugh classification, or the grade of PHG (p > 0.05).

Conclusion: Esophageal EVL is associated with a higher frequency of developing DU, which is related to a larger number of applied bands but is not correlated with Hp infection status or other variables.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adolescent
  • Child
  • China / epidemiology
  • Duodenal Ulcer / epidemiology*
  • Endoscopy, Gastrointestinal
  • Esophageal and Gastric Varices / complications
  • Esophageal and Gastric Varices / surgery*
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / surgery*
  • Helicobacter Infections / epidemiology*
  • Humans
  • Hypertension, Portal / complications*
  • Incidence
  • Ligation* / methods
  • Logistic Models
  • Male
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Stomach Diseases / diagnosis
  • Stomach Diseases / etiology*
  • Stomach Diseases / physiopathology
  • Treatment Outcome