A Retrospective Analysis of Endoscopic Variceal Ligation Outcomes for Secondary Prophylaxis of Esophageal Variceal Bleeding in Western India

Abstract

Objectives:
To assess the clinical outcomes of Endoscopic Variceal Ligation (EVL) in the secondary prevention of esophageal variceal bleeding among cirrhotic patients in a tertiary care hospital in Western India.

Methods:
This retrospective study analyzed prospectively collected data from 34 cirrhotic patients who underwent EVL following esophageal variceal bleeding. Clinical outcomes, including 90-day rebleeding and mortality rates, were evaluated. Independent predictors of rebleeding were identified through multivariate analysis.

Results:
Immediate hemostasis was achieved in all patients (100%). The 90-day rebleeding rate was 14.7%, and the 90-day all-cause mortality was 5.9%. An INR >1.5 and Child–Pugh Class C liver disease were identified as independent predictors of rebleeding.

Conclusions:
EVL is effective in achieving immediate hemostasis and reducing early rebleeding and mortality in cirrhotic patients, even in resource-limited settings. Elevated INR and advanced liver disease significantly increase the risk of rebleeding. These findings reaffirm the critical role of EVL in the secondary prevention of variceal bleeding.