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Endoscopic band ligation versus argon plasma coagulation in non-variceal upper gastrointestinal bleeding in children with portal hypertension /

Mohamed Ahmed Rabea

Endoscopic band ligation versus argon plasma coagulation in non-variceal upper gastrointestinal bleeding in children with portal hypertension / دراسة مقارنة بين ربط المعدة و كيها بغاز الأرجون لعلاج نزيف الجهاز الهضمى الغير ناتج عن الدوالى نتيجة ارتفاع ضغط الوريد البابى فى الأطفال Mohamed Ahmed Rabea ; Supervised Nabil Abdelaziz Mohsen , Ayman Emil Eskander , Carolyne Morcos Ghobrial - Cairo : Mohamed Ahmed Rabea , 2017 - 117 P. : charts , facsimiles ; 25cm

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Gastric antral vascular ectasia (GAVE) and Portal hypertensive gastropathy (PHG) may cause recurrent hemorrhage and thus, chronic anemia, in patients with portal hypertension. Treatment with argon plasma coagulation (APC) is an effective and safe method in adults, but requires multiple sessions of endoscopic therapy. Endoscopic band ligation (EBL) was found to be a good alternative for APC as a treatment for GAVE, especially in refractory cases. The aim of this prospective study was to evaluate the safety and efficacy of EBL, as compared to APC, in the treatment of bleeding from PHG and/or GAVE in children with portal hypertension. Patients and methods: A total of 40 pediatric patients with GAVE and/ or PHG were prospectively randomized to endoscopic treatment with either EBL or APC, every 3-4 weeks until complete obliteration was accomplished. Hemoglobin level was obtained before and after treatments; then they were followed up endoscopically after 6 months with documentation of the recurrence of the lesion if that occurred. Results: We found that EBL significantly decreased the number of sessions required for complete obliteration of the lesions (1.85±0.81 sessions compared to 4.15±1.22 sessions in the APC group (p<0.05)). Also, EBL was significantly superior to APC as regards lower rate of recurrence during the treatment and follow up period (p<0.05) and higher rate of endoscopic cure after the follow up period p<0.05



Argon plasma coagulation Endoscopic band ligation Gastric antral vascular ectasia