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Endoscopic Band Ligation
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Endoscopic Band Ligation

(Esophageal Band Ligation)

En Español (Spanish Version)

Definition

Endoscopic band ligation is a procedure to treat enlarged veins in the throat. Elastic bands are placed around the enlarged veins (varices) in the throat (esophagus). Endoscopic band ligation is performed as part of an upper gastrointestinal (GI) endoscopy.

Banded Blood Vessel

band ligation

© 2008 Nucleus Medical Art, Inc.

Parts of the Body Involved

  • Mouth
  • Throat
  • Esophagus

Reasons for Procedure

Endoscopic band ligation is performed to treat esophageal varices. If left untreated, esophageal varices could rupture and bleed severely.

Risk Factors for Complications During the Procedure

  • Age: 60 or older
  • Pregnancy
  • Obesity
  • Smoking
  • Malnutrition
  • Recent or chronic illness
  • Diabetes
  • Heart or lung problems
  • Bleeding disorders
  • Alcoholism
  • Use of certain medications
  • Use of illegal drugs

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • Blood tests

In the days leading up to your procedure:

  • The night before, eat a light meal and do not eat or drink anything after midnight, unless directed otherwise by your doctor.
  • Take medications, if prescribed by your doctor.
  • Arrange to have someone drive you to and from the procedure, and for help at home after your procedure.

Anesthesia

  • Local—You may be given an anesthetic solution to gargle, or your throat may be sprayed with a numbing anesthetic. You may also be given a sedative to help you relax.
  • Conscious sedation—You may be given medications through an intravenous (IV) to help you relax and to treat any pain you feel during the procedure.

Description of the Procedure

You may be asked to lie on your left side. You will have monitors that will track your breathing, heart rate, and blood oxygen levels. You may also be given supplemental oxygen to breathe through your nose.

A supportive device will be positioned in your mouth to help keep it open during the procedure. A suction tube will be used to clear the saliva and other fluids from your mouth.

Then your doctor will place a lubricated endoscope (a small, flexible tube containing a light and video camera) into your mouth, down your throat, and into your esophagus. As the endoscope advances, the doctor can view the inside of your digestive tract and locate the enlarged vein. Air will be introduced into the endoscope to help your doctor see your esophagus.

Once your doctor has located the vein, he or she will need to remove the endoscope and attach the banding device to the end of the scope. He or she will then repass the scope into the esophagus and suck the enlarged tissue into the device’s chamber and place one or more bands around it.

After Procedure

You will be taken to a recovery area until the effects of your medications have worn off.

How Long Will It Take?

The procedure typically takes less than one hour.

Will It Hurt?

You will usually feel some pressure and discomfort but no pain during the procedure. After the procedure, your throat may feel irritated and sore.

Possible Complications

  • Bleeding
  • Accidental perforation of the esophagus
  • Abnormal heartbeat
  • Aspiration (breathing fluids into the lungs, which can lead to pneumonia)
  • Infection
  • Fever
  • Reduced breathing rate and/or depth
  • Adverse reaction to sedatives or numbing anesthetics

Average Hospital Stay

In most cases, you will be observed for about an hour and then allowed to go home.

Postoperative Care

After returning home, you should do the following:

  • Follow your doctor's instructions regarding your diet.
  • Avoid driving or using heavy machinery for at least a day after your procedure, since sedatives may slow your reaction time.
  • Avoid drinking alcohol for at least a day after your procedure.
  • Get plenty of rest.

Outcome

In the days or weeks after your procedure, the tissue that was banded will slough off.

Call Your Doctor If Any of the Following Occurs

  • Increasing or persistent pain
  • Severe abdominal pain
  • Bleeding
  • Fever
  • Nausea and vomiting
  • Bloody bowel movements
  • Extreme dizziness or weakness
  • Difficulty breathing
  • Difficulty swallowing
  • Increase of or change in your original symptoms

RESOURCES:

American Society for Gastrointestinal Endoscopy
http://www.asge.org

National Institute of Diabetes and Digestive and Kidney Diseases
http://www2.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
http://www.cag-acg.org

Health Canada
http://www.hc-sc.gc.ca/index_e.html

References:

Endoscopic hemostatic devices. American Society for Gastrointestinal Endoscopy website. Available at: http://www.asge.org/nspages/practice/patientcare/technology/hemostatdevices.cfm. Accessed April 18, 2007.

Upper GI endoscopy. UCSF Gastroenterology Division website. Available at: http://gi.ucsf.edu/proc_upperEndo.html. Accessed April 18, 2007.



Last reviewed May 2008 by Daus Mahnke, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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