Endoscopic Variceal Ligation (EVL)

Effective Treatment for Esophageal Varices to Prevent GI Bleeding

What is Endoscopic Variceal Ligation (EVL)?

Endoscopic Variceal Ligation (EVL) is a minimally invasive procedure used to treat esophageal varices—enlarged veins in the esophagus that are prone to bleeding. These varices most commonly occur in patients with liver disease, such as cirrhosis, and can lead to life-threatening gastrointestinal (GI) bleeding if left untreated.

At Central Gastro, we specialize in EVL to safely and effectively manage esophageal varices, reduce bleeding risks, and provide comprehensive care for patients with liver-related GI complications.

Why is EVL Performed?

EVL is recommended to:

• Prevent Bleeding: Proactively treat high-risk esophageal varices before they rupture.
• Stop Active Bleeding: Control acute bleeding from esophageal varices.
• Reduce the Risk of Recurrence: Manage varices over time to prevent further complications.

Patients with chronic liver disease, portal hypertension, or a history of GI bleeding are at higher risk for esophageal varices and may benefit from this procedure.

What Causes Esophageal Varices?

Esophageal varices develop due to increased pressure in the portal vein (portal hypertension), often caused by:

• Liver Cirrhosis: Scarring of the liver due to alcohol abuse, hepatitis, or fatty liver disease.
• Chronic Liver Disease: Conditions that impair liver function over time.
• Blood Clots in the Portal Vein: Obstructions that increase blood pressure in the portal system.

How is Endoscopic Variceal Ligation Performed?

EVL is performed using an endoscope, a thin, flexible tube with a light and camera, under sedation for your comfort:

1. Preparation
   • Unless it is an emergency, you will need to fast for 4-6 before the procedure.
   • Sedation will be administered to keep you relaxed.
2. Procedure
   • The endoscope is carefully inserted through the mouth into the esophagus.
   • Using a specialized banding device attached to the endoscope, the enlarged varices are located.
   • Small rubber bands are placed around the varices to cut off their blood supply.
   • Over time, the banded varices shrink, scar, and fall off naturally.
3. Recovery
   • The procedure typically takes 30–45 minutes.
   • You will be monitored in recovery until the sedation wears off and can usually go home the same day.

Benefits of Endoscopic Variceal Ligation

• Minimally Invasive: No incisions; performed endoscopically.
• Highly Effective: Safely controls and prevents bleeding from esophageal varices.
• Quick Recovery: Short procedure with minimal downtime.
• Reduces Risk of Life-Threatening Bleeding: Essential for patients with cirrhosis and portal hypertension.

What to Expect After EVL

• Dietary Changes: You may need to stick to soft or liquid foods for 1–2 days to allow the esophagus to heal.
• Temporary Discomfort: Mild chest pain, throat soreness, or difficulty swallowing is common but temporary.
• Follow-Up: Repeat EVL sessions may be necessary to fully treat varices and prevent recurrence. Regular monitoring with endoscopy will be scheduled.

If you experience symptoms such as vomiting blood, black tarry stools, or signs of anemia (fatigue, dizziness), seek immediate medical care.