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

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