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Erschienen in: Digestive Diseases and Sciences 4/2023

21.09.2022 | Original Article

Band Ligation Can Be Used to Treat Barrett’s Esophagus and Concurrent Esophageal Varices: A Case Series

verfasst von: Colin Hartgerink, Faisal M. Nimri, Tobias Zuchelli, Syed-Mohammed Jafri, Cyrus Piraka

Erschienen in: Digestive Diseases and Sciences | Ausgabe 4/2023

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Abstract

Background

Patients with Barrett’s esophagus (BE) and esophageal varices present a unique management dilemma. Endoscopic ablation and endoscopic resection are not suitable treatment options due to bleeding risk. Data are limited on successful eradication of BE and esophageal varices utilizing band ligation.

Aims

To assess the outcomes of patients with BE and esophageal varices treated with banding.

Methods

Retrospective analysis of patients with BE and esophageal varices who were treated with band ligation.

Results

A total of eight patients were included in the case series. In all eight cases, BE and esophageal varices were successfully treated with band ligation alone. There were no bleeding, perforation or infectious complications in any patients undergoing banding for treatment of BE. Four patients had biopsy-proven dysplasia prior to treatment with band ligation. After band ligation, the 2 of 4 dysplastic cases that had repeat biopsies showed histologic resolution of the dysplasia. All patients who received banding for BE were followed at least yearly except for one patient lost to follow up. No interval esophageal cancers were reported in any patients with BE that were banded.

Conclusions

Band ligation was used to treat BE pathology in eight patients with esophageal varices. Treatment of dysplasia through this method yielded negative biopsies both for dysplasia and BE on repeat endoscopy. This case series highlights the value of utilizing band ligation to address the management dilemma of BE in the context of esophageal varices.
Literatur
1.
Zurück zum Zitat Naini BV, Souza RF, Odze RD. Barrett’s esophagus: a comprehensive and contemporary review for pathologists. Am J Surg Pathol 2016;40:e45–e66.CrossRefPubMedPubMedCentral Naini BV, Souza RF, Odze RD. Barrett’s esophagus: a comprehensive and contemporary review for pathologists. Am J Surg Pathol 2016;40:e45–e66.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Hayeck TJ, Kong CY, Spechler SJ, Gazelle GS, Hur C. The prevalence of Barrett’s esophagus in the US: estimates from a simulation model confirmed by SEER data. Dis Esophagus 2010;23:451–457.CrossRefPubMed Hayeck TJ, Kong CY, Spechler SJ, Gazelle GS, Hur C. The prevalence of Barrett’s esophagus in the US: estimates from a simulation model confirmed by SEER data. Dis Esophagus 2010;23:451–457.CrossRefPubMed
3.
4.
Zurück zum Zitat Puente A, Hernández-Gea V, Graupera I et al. Drugs plus ligation to prevent rebleeding in cirrhosis: an updated systematic review. Liver Int 2014;34:823–833.CrossRefPubMed Puente A, Hernández-Gea V, Graupera I et al. Drugs plus ligation to prevent rebleeding in cirrhosis: an updated systematic review. Liver Int 2014;34:823–833.CrossRefPubMed
6.
Zurück zum Zitat Ueda C, Yosizaki T, Katayama N et al. Barrett’s adenocarcinoma with esophageal varices successfully treated by endoscopic submucosal dissection with direct varices coagulation. Clin J Gastroenterol 2020;13:178–181.CrossRefPubMed Ueda C, Yosizaki T, Katayama N et al. Barrett’s adenocarcinoma with esophageal varices successfully treated by endoscopic submucosal dissection with direct varices coagulation. Clin J Gastroenterol 2020;13:178–181.CrossRefPubMed
8.
Zurück zum Zitat Raftopoulos SC, Efthymiou M, May G, Marcon N. Dysplastic Barrett’s esophagus in cirrhosis: a treatment dilemma. Am J Gastroenterol 2011;106:1724–1726.CrossRefPubMed Raftopoulos SC, Efthymiou M, May G, Marcon N. Dysplastic Barrett’s esophagus in cirrhosis: a treatment dilemma. Am J Gastroenterol 2011;106:1724–1726.CrossRefPubMed
9.
Zurück zum Zitat Palmer WC, Di Leo M, Jovani M et al. Management of high grade dysplasia in Barrett’s oesophagus with underlying oesophageal varices: a retrospective study. Dig Liver Dis 2015;47:763–768.CrossRefPubMed Palmer WC, Di Leo M, Jovani M et al. Management of high grade dysplasia in Barrett’s oesophagus with underlying oesophageal varices: a retrospective study. Dig Liver Dis 2015;47:763–768.CrossRefPubMed
10.
Zurück zum Zitat Diaz-Cervantes E, De-la-Torre-Bravo A, Spechler SJ et al. Banding without resection (endoscopic mucosal ligation) as a novel approach for the ablation of short-segment Barrett’s epithelium: results of a pilot study. Am J Gastroenterol 2007;102:1640–1645.CrossRefPubMed Diaz-Cervantes E, De-la-Torre-Bravo A, Spechler SJ et al. Banding without resection (endoscopic mucosal ligation) as a novel approach for the ablation of short-segment Barrett’s epithelium: results of a pilot study. Am J Gastroenterol 2007;102:1640–1645.CrossRefPubMed
11.
Zurück zum Zitat Chadwick G, Groene O, Markar SR, Hoare J, Cromwell D, Hanna GB. Systematic review comparing radiofrequency ablation and complete endoscopic resection in treating dysplastic Barrett’s esophagus: a critical assessment of histologic outcomes and adverse events. Gastrointest Endosc 2014;79:718-731.e3.CrossRefPubMed Chadwick G, Groene O, Markar SR, Hoare J, Cromwell D, Hanna GB. Systematic review comparing radiofrequency ablation and complete endoscopic resection in treating dysplastic Barrett’s esophagus: a critical assessment of histologic outcomes and adverse events. Gastrointest Endosc 2014;79:718-731.e3.CrossRefPubMed
12.
Zurück zum Zitat Shaheen NJ, Sharma P, Overholt BF et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med 2009;360:2277–2288.CrossRefPubMed Shaheen NJ, Sharma P, Overholt BF et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med 2009;360:2277–2288.CrossRefPubMed
13.
Zurück zum Zitat Orman ES, Li N, Shaheen NJ. Efficacy and durability of radiofrequency ablation for Barrett’s esophagus: systematic review and meta-analysis. Clin Gastroenterol Hepatol 2013;11:1245–1255.CrossRefPubMed Orman ES, Li N, Shaheen NJ. Efficacy and durability of radiofrequency ablation for Barrett’s esophagus: systematic review and meta-analysis. Clin Gastroenterol Hepatol 2013;11:1245–1255.CrossRefPubMed
14.
Zurück zum Zitat Ma GK, Ginsberg GG. Radiofrequency ablation of Barrett’s esophagus: patient selection, preparation, and performance. Gastrointest Endosc Clin N Am 2017;27:481–490.CrossRefPubMed Ma GK, Ginsberg GG. Radiofrequency ablation of Barrett’s esophagus: patient selection, preparation, and performance. Gastrointest Endosc Clin N Am 2017;27:481–490.CrossRefPubMed
15.
Zurück zum Zitat Weston AP, Sharma P, Topalovski M, Richards R, Cherian R, Dixon A. Long-term follow-up of Barrett’s high-grade dysplasia. Am J Gastroenterol. 2000;95:1888–1893.CrossRefPubMed Weston AP, Sharma P, Topalovski M, Richards R, Cherian R, Dixon A. Long-term follow-up of Barrett’s high-grade dysplasia. Am J Gastroenterol. 2000;95:1888–1893.CrossRefPubMed
16.
Zurück zum Zitat Holster IL, Tjwa ET, Moelker A et al. Covered transjugular intrahepatic portosystemic shunt versus endoscopic therapy + β-blocker for prevention of variceal rebleeding. Hepatology 2016;63:581–589.CrossRefPubMed Holster IL, Tjwa ET, Moelker A et al. Covered transjugular intrahepatic portosystemic shunt versus endoscopic therapy + β-blocker for prevention of variceal rebleeding. Hepatology 2016;63:581–589.CrossRefPubMed
Metadaten
Titel
Band Ligation Can Be Used to Treat Barrett’s Esophagus and Concurrent Esophageal Varices: A Case Series
verfasst von
Colin Hartgerink
Faisal M. Nimri
Tobias Zuchelli
Syed-Mohammed Jafri
Cyrus Piraka
Publikationsdatum
21.09.2022
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 4/2023
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-022-07696-1

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