A retrospective analysis of the efficacy of endoscopic variceal ligation versus endoscopic tissue adhesive injection in the treatment of esophagogastric variceal bleeding

Abstract Objective To investigate the effectiveness and safety of endoscopic variceal ligation (EVL) and endoscopic tissue adhesive injection (TAI) in the treatment of esophagogastric variceal bleeding. Methods 245 patients with esophagogastric variceal bleeding attending the First Affiliated Hospital of Bengbu Medical College from December 2017 to June 2021 were retrospectively collected and divided into 103 patients in the esophageal EVL(E-EVL) + gastric EVL(G-EVL) group and 142 patients in the E-EVL + gastric TAI(G-TAI) group according to the procedure, comparing and assessing the clinical characteristics, laboratory results, operation time, rebleeding rate, efficacy, and complications in the two groups. Results The diameter of the varicose veins and the operative time were significantly less in the E-EVL + G-EVL group than in the E-EVL + G-TAI group (p < 0.05), there was no statistical difference in the length of stay in hospital between the two groups (p > 0.05). The total rebleeding rate in the E-EVL + G-EVL group was 9.7%; the total rebleeding rate in the E-EVL + G-TAI group was 11.9%, and there was no statistical difference between the two groups (P > 0.05). The overall effective rate of the E-EVL + G-EVL group was 90.21%; the overall effective rate of the E-EVL + G-TAI group was 92.81%, and there was no statistical difference between the two groups (P > 0.05). The postoperative ulcer in the E-EVL + G-EVL group were smaller and more superficial than those in the E-EVL + G-TAI group, and the wound surface was smoother. Conclusion Both endoscopic variceal ligation and endoscopic tissue adhesive injection have good therapeutic effects on esophagogastric variceal bleeding, and gastric endoscopic variceal ligation is worthy of further clinical promotion because of its effectiveness in preventing re-bleeding, no reduction in efficacy and no increase in complications, shortened operative time, smaller and superficial ulcer and smoother wounds.