Background: Gastric Antral Vascular Ectasia (GAVE) is a capillarytype vascular malformation located mainly in the gastric antrum. It is
characterized by dilated, tortuous mucosal capillaries and submucosal
veins. Aim of the work: to evaluate the therapeutic effects of
Endoscopic Band Ligation (EBL) for the treatment of bleeding from
GAVE in comparison to Argon Plasma Coagulation (APC). Patients
and Methods: This prospective randomized study was conducted on
fifty patients presenting with Upper Gastro Intestinal Bleeding (UGIB)
that proved by Gastro Duodenoscopy to be originating from GAVE at
Kafr El Sheikh liver center every Tuesday weekly in the period from
December 2019 to December 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. Duodenoscopy 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. |
