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Endoscopic Band Ligation by Krisha McCoy, MS

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

Esophageal varices are abnormal blood vessels (veins) that develop in the esophagus. They have abnormally thin walls, and the blood pressure within them is very high. This combination makes esophageal varices very dangerous, because they can burst and cause life-threatening bleeding.

Endoscopic band ligation is the use of elastic bands to treat the varices. It is done as part of an upper gastrointestinal (GI) endoscopy .

Banded Blood Vessel

Reasons for Procedure

This procedure is done to treat esophageal varices (enlarged veins). If left untreated, varices could rupture and bleed severely.

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have an endoscopic band ligation, your doctor will review a list of possible complications, which may include:

Painful swallowing
Bleeding
Esophageal damage
Infection

Some factors that may increase the risk of complications include:

Alcoholism
Bleeding disorder
Active bleeding
Advanced age
Heart or lung problems
Use of certain medicines
Smoking

What to Expect

Prior to Procedure

Your doctor will likely do the following:
- Physical exam
- Blood tests
Do not eat for 8 to 12 hours before the procedure.
If you have diabetes , discuss your medicines with your doctor.
Arrange for transportation after the procedure. You should not drive for 24 hours after the procedure.
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

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 medicines through an IV. It will help you relax. Other medicines will be given to treat any pain you feel during the procedure.

Description of the Procedure

For this procedure, you will lie on your left side. A mouthpiece will be placed to help keep your mouth open. An assistant will be in the room to monitor your breathing and heart beat. You may also be given oxygen through your nose. A suction tube will be used to clear the saliva and other fluids from your mouth.

A lubricated endoscope will be placed into your mouth. It will be passed down your throat and into your esophagus. The scope will have a small light and a camera. The doctor will watch the images on a video monitor. Air will be passed through the scope to help your doctor see your esophagus. The doctor will be able to locate the enlarged vein.

Instruments will be passed through the scope. The enlarged tissue will be sucked into the device’s chamber. One or more bands will be placed around the tissue to clamp off the blood supply.

How Long Will It Take?

Typically, less than one hour

Will It Hurt?

You will usually feel some pressure and discomfort, but not pain, during the procedure. After the procedure, your throat may feel irritated and sore.

Post-procedure Care

At the Care Center

You will be taken to a recovery area until the effects of your medicines have worn off. In most cases, you will be observed for about an hour. If you feel well, you can then go home.

At Home

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. Sedatives may slow your reaction time.
Avoid drinking alcohol for at least a day after your procedure.
Get plenty of rest.

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

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

Signs of infection, including fever and chills
Bleeding from the mouth
Increasing pain
Nausea and vomiting
Bloody vomit
Difficulty swallowing
Cough, shortness of breath, or chest pain
Dizziness or weakness
Bloody or dark black stools
Severe abdominal pain

In case of an emergency, call for medical help right away.

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 September 2012 by Daus Mahnke, MD

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