Endoscopic Band Ligation versus Argon Plasma Coagulation in Treatment of Gastric Antral Vascular Ectasia

摘要

Objective: To evaluate the therapeutic effects of endoscopic band ligation (EBL) as a modality for the treatment of bleeding from gastric antral vascular ectasia (GAVE) in comparison to argon plasma coagulation (APC) in Egyptian patients. Background: Argon Plasma Coagulation (APC) is considered the standard commonly used treatment for Gastric antral vascular ectasia (GAVE). Recently, the use of banding in the gastric antrum has been evaluated for the treatment of GAVE. Methods: The study was conducted on thirty patients presenting with bleeding from GAVE. The patients were divided into two groups: Group I (EBL) group: 15 patients were subjected to EBL. Group II (APC) group: 15 patients were subjected to APC. Sessions were done every 3 weeks till satisfactory endoscopic ablation was achieved. Regular endoscopic assessment at 3 months was done with documentation of the recurrence of GAVE if found. Results revealed that thirteen patients were males and seventeen were females with age ranging from 51-70 years old. Most of the patients presented with overt bleeding (hematemesis and/or melena) (67%) in the APC group and (67%) in the EBL group. In endoscopic band ligation group, all patients (100%) showed complete improvement with no upper gastrointestinal endoscopic recurrence. In APC 10 patients, (67%) showed complete improvement with no upper gastrointestinal endoscopic recurrence, 5 patients (33 %) showed no upper gastrointestinal endoscopic improvement. In conclusion , EBL is a better treatment modality for GAVE than APC.