LAUSR

OBJECTIVE This study aimed to compare the effectiveness of endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL) in managing esophageal varices (EVs) according to the diameter of para-esophageal varices (PEVs) on computed tomography (CT). METHODS In this retrospective study, EIS and EVL were compared as initial and palliative treatments for patients with EVs who were treated at our hospital from 2012 to 2017. The PEV diameter was measured using CT, and EVL treatment was chosen for patients with PEVs >4 mm. Overall survival (OS), rebleeding rate (RBR), and retreatment rate (RTR) were compared between patients treated with EIS and EVL. RESULTS Thirty-seven patients treated with EIS and 41 treated with EVL were enrolled. A significantly lower prevalence of HCC (13.5% vs. 39.0%, P < 0.01) and higher serum Albumin level (3.6 ± 0.5 mm vs. 3.2 ± 0.6 mm, P < 0.01) were observed in patients treated with EIS than in those treated EVL. Although OS was significantly worse in patients treated with EVL (P < 0.01), RBR and RTR were not significantly different . To balance the patients' background characteristics, propensity score matching analysis was performed; 18 patients treated with EIS and 18 treated with EVL were compared. OS, RBR, and RTR did not significantly differ after matching. CONCLUSIONS In our algorithm, EVL was as effective as EIS for treating patients with EV. The usefulness of measuring PEV to determine the efficacy of EVL or EIS in patients with EV was demonstrated. This article is protected by copyright. All rights reserved.