Efficacy of Endoscopic band ligation versus argon plasma coagulation inGastric Antral Vascular Ectasia management

Nassar, Ashraf; Mohamed, Hisham S; Soliman, Mostafa Mohamed; Elazab, Tamer Eleraky

doi:10.21608/bmfj.2022.101084.1504

Efficacy of Endoscopic band ligation versus argon plasma coagulation inGastric Antral Vascular Ectasia management

Document Type : Original Article

Authors

¹ Gastroenterology &amp; Hepatology department, Faculty of Medicine-Benha University.

² Gastroenterology &amp; Hepatology department, Faculty of Medicine-Benha University

³ Faculty of Medicine, Benha University

⁴ hepatology,gastroentrology and infectious disease

10.21608/bmfj.2022.101084.1504

Abstract

Background: Gastric Antral Vascular Ectasia (GAVE) is a capillary-type vascular malformation located mainly in the gastric antrum. It is characterized by dilated, tortuous mucosal capillaries, as well as by dilated, tortuous submucosal veins.Aim of the work: to evaluate the therapeutic effects of EBL for the treatment of bleeding from GAVE in comparison to APC. Patients and Methods: This study was conducted on fifty patients presenting withUGI bleeding that proved by upper GIE to be originating from GAVE at Kafr El Sheikh liver center every Tuesday weekly in the period from December 2019 toDecember 2020. Informed consent was obtained from each patient.Results: In this study hemoglobin levels were significantly raised after each endoscopic session done monthly through three months/four endoscopic follow up sessions in patients who underwent EBL and APC with no significant difference between both. Also, recurrence of bleeding from GAVE was significantly decreasing during follow up period in both groups with non-significant difference between both groups. Both groups showed non-significant mild complications like superficial ulcers and gastric hyperplastic polyps with non-significant difference between both. UGI endoscopic follow up after 3 months of treatment showed marked improvement in patients treated with EBL and APC. two patients in each group showed incomplete eradication of GAVE at fourth endoscopic follow up session requiring further follow up. Single patient showed recurrence of GAVE in EBL group with no recurrences in APC group. Conclusion: both APC and EBL are safe and effective management options for both punctate and watermelon types of GAVE.

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