• Dingguo Zhang, Ruiyue Shi, Jun Yao, Ru Zhang, Zhenglei Xu, and Lisheng Wang.
• Hepato Gastroenterol. 2015 Jan 1; 62 (137): 77-81.

Background/AimsTo evaluate the effectiveness of improved sengstaken-blackmore tube combined with intensive endoscopic detachable mini-loop ligation for the treatment of massive esophageal variceal bleeding (EVB).MethodologyEighty-three patients diagnosed with massive EVB and admitted from January 2005 to July 2011 were retrospectively evaluated. Upon admission, all patients received 12 h balloon tamponade with sengstaken-blackmore tube in addition to conventional therapy (blood volume resuscitation, prophylactic antibiotics and somatostatin). Within 24 h after admission, all patients further received endoscopic variceal ligation (EVL) with intensive endoscopic detachable nylon ring (mini-loop).ResultsNo severe complications were observed after the patients received the 12 h consistent compression with sengstaken-blackmore tube. Eighty-two patients (98.8%) showed effective hemostasis, among which seventy-eight showed complete hemostasis. After receiving the subsequent EVL therapy with intensive endoscopic detachable mini-loop in 24 h after admission, patients did not show active bleeding in 24 h after EVL. Rehaemorrhagia appeared only in one patient within the 7 days of observation period, which was controlled by a second EVL. Each patient was ligated with 10 to 15 loops.ConclusionsEVB can be effectively treated with improved sengstaken-blackmore tube followed by EVL therapy with intensive endoscopic detachable mini-loop.

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