Endoscopic Variceal Ligation (EVL)
Endoscopic Variceal Ligation (EVL), also called esophageal variceal band ligation, is a minimally invasive procedure used to treat enlarged veins in the esophagus. These varices can develop when increased portal pressure redirects blood through fragile veins. Bleeding from esophageal varices can be serious and requires urgent medical attention.
Who May Need EVL?
A gastroenterologist may recommend endoscopic variceal ligation for high-risk esophageal varices or after esophageal variceal bleeding. Treatment depends on variceal size, bleeding history, liver disease, and overall health.
How Is Esophageal Variceal Banding Performed?
During an upper GI endoscopy, a flexible endoscope is guided through the mouth into the esophagus. The doctor places small elastic bands around selected varices. The bands restrict blood flow, allowing treated veins to shrink. EVL may require repeat sessions and follow-up endoscopy until the varices are controlled.
Benefits of EVL
Endoscopic variceal ligation can help control acute esophageal variceal bleeding and reduce recurrent bleeding risk in appropriately selected patients. It is performed through an endoscope rather than open surgery. Doctors may also recommend medicines and monitoring for portal hypertension and underlying liver disease.
Preparation and Recovery
Patients should follow fasting instructions before upper GI endoscopy and tell their doctor about medicines, allergies, and health conditions. Temporary throat or chest discomfort may occur afterward. Seek urgent care for vomiting blood, black stools, severe chest or abdominal pain, breathing difficulty, fever, or worsening swallowing problems.