ABSTRACT
Endoscopic treatments for bleeding gastwesophageal varices include injection sclerotherapy,
variceal obturation with tissue adhesives, and variceal rubber band ligation. Acute
injection sclerotherapy remains a quick and simple technique for the control of active
bleeding from esophageal varices. Although few trials have been published so far,
some evidence suggests that the early administration of vasoactive drugs (somatostatin,
octreotide, or terlipressin) is safe and may increase the efficacy of endoscopic treatments.
Banding ligation is the optimal endoscopic treatment for the prevention of reblee
ding from esophageal varices. The use of tissue adhesives and thrombin as injectates
to treat bleeding fundal gastric varices and esophageal varices not responding to
vasoactive drugs or sclerotherapy is promising but needs further assessment by means
of randomized controlled trials. As of to-day, endoscopic treatments are not recommended
for the primary prophylaxis of variceal bleeding.
KEY WORDS
variceal bleeding - endoscopic treatment - meta-analysis
