Εndoscopic sclerotherapy and variceal ligation: Nursing approach

The increased morbidity rate, as well as the considerable mortality rate that oesophageal varices induce, render variceal bleeding prevention and therapy crucial to the overall treatment of portal hypertension. For this reason, there are two endoscopic techniques broadly used: the endoscopic sclerotherapy (EST) and the endoscopic variceal ligation (EVL). Aim: A review on the nurse’s role and significance in the endoscopic techniques of sclerotherapy (EST) and variceal ligation (EVL) based on recent bibliography. Material - Method: An overview of resent Greek and international literature mainly of nursing interest published during the last 25 years, on Medline. Results: EST remains the corner stone of acute variceal bleeding treatment. On the other hand, EVL has become the endoscopic treatment of choice for the prevention of recurrence of this serious portal hypertension complication. However, their implementation in variceal bleeding primary prevention is confined only to cases that medication is either inadvisable or ineffective. EVL displays more technical difficulties when compared with EST and requires further experience, although complications of the former are altogether fewer and less significant than those of the latter. Conclusions: The nurse who is integrally trained and familiarized plays a significant role both in the evaluation of the patient’s clinical course before, during and after the endoscopic process, and the appreciation of whether the endoscopic implementation has achieved its aims or not.

Keywords: Gastroesophageal varices, variceal bleeding, endoscopic sclerotherapy, endoscopic variceal ligation