Efficiency and Safety of Endoscopic Injection Sclerotherapy With Ligation for Esophageal Varices: A Retrospective Study.

ABSTRACT Objectives Endoscopic injection sclerotherapy with ligation (EISL) is a combined endoscopic treatment that involves endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation. This study aimed to compare the efficacy of conventional EIS and EISL in treating esophageal varices and the usefulness of EISL. Methods A total of 104 cases treated with conventional EIS and 44 cases treated with EISL for esophageal varices were included in the study. The procedure duration, intra‐injection volume, and para‐injection volume, the success rate of intravascular injection based on variceal type, recurrence‐free survival, and post‐treatment adverse events were assessed. Results The procedure duration was significantly shorter in the EISL group (13.1 ± 7.2 min) than in the conventional EIS group (20.7 ± 8.0 min; p < 0.0001). Additionally, the para‐injection volume per session was lower in the EISL group (0.7 ± 1.0 mL) than in the conventional EIS group (1.2 ± 1.1 mL; p = 0.0426). The intravascular injection success rate was higher in the EISL group for all variceal morphologies, particularly for F1/F2 esophageal varices. In terms of post‐treatment adverse events, the frequency of fever was lower in the EISL group than in the conventional EIS group ( p = 0.008). There was no significant difference in recurrence‐free survival between the conventional EIS and EISL groups. Conclusions Compared with conventional EIS, EISL required shorter procedure times and reduced paravariceal leakage of the injected sclerosant. EISL also demonstrated higher success rates, particularly for small varices, and fewer post‐treatment adverse events.