تعريف
Esophageal varices are abnormal blood vessels (veins) that develop in the esophagus. They have abnormally thin walls, and the blood pressure within them is very high. This combination makes esophageal varices very dangerous, because they can burst and cause life-threatening bleeding.
Endoscopic band ligation is the use of elastic bands to treat the varices. It is done as part of an upper gastrointestinal (GI) endoscopy.
أسباب هذا الإجراء
This procedure is done to treat esophageal varices (enlarged veins). If left untreated, varices could rupture and bleed severely.
المضاعفات المحتملة
Complications are rare, but no procedure is completely free of risk. If you are planning to have an endoscopic band ligation, your سيقوم الطبيب بمراجعة القائمة من المضاعفات المحتملة، والتي قد تشمل:
- Painful swallowing
- نزيف
- Esophageal damage
- العدوى
بعض العوامل التي قد تزيد من خطر المضاعفات تشمل:
- إدمان الكحول
- اضطراب النزيف
- Active bleeding
- سن متقدم
- مشاكل في القلب أو الرئة
- استخدام بعض الأدوية
- التدخين
ما يمكن توقعه
قبل الإجراء
- طبيبك سوف المرجح أن تفعل ما يلي:
- اختبار بدني
- تحاليل الدم
- Do not eat for 8 to 12 hours before the procedure.
- If you have diabetes, discuss your medicines with your doctor.
- Arrange for transportation after the procedure. You should not drive for 24 hours after the procedure.
- التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:
- الأسبرين أو غيره من العقاقير المضادة للالتهابات
- سيولة الدم, مثل كلوبيدوجريل (بلافيكس) أو الوارفارين (الكومادين)
التخدير
- Local—You may be given an anesthetic solution to gargle, or your throat may be sprayed with a numbing anesthetic.
- You may also be given a sedative to help you relax.
- Conscious sedation—You may be given medicines through an IV. It will help you relax. Other medicines will be given to treat any pain you feel during the procedure.
وصف الإجراء
For this procedure, you will lie on your left side. A mouthpiece will be placed to help keep your mouth open. An assistant will be in the room to monitor your breathing and heart beat. You may also be given oxygen through your nose. A suction tube will be used to clear the saliva and other fluids from your mouth.
A lubricated endoscope will be placed into your mouth. It will be passed down your throat and into your esophagus. The scope will have a small light and a camera. The doctor will watch the images on a video monitor. Air will be passed through the scope to help your doctor see your esophagus. The doctor will be able to locate the enlarged vein.
Instruments will be passed through the scope. The enlarged tissue will be sucked into the device’s chamber. One or more bands will be placed around the tissue to clamp off the blood supply.
كم من الوقت سيستغرق ؟
Typically, less than one hour
هل سيكون هناك ألم؟
You will usually feel some pressure and discomfort, but not pain, during the procedure. After the procedure, your throat may feel irritated and sore.
رعاية ما بعد العملية
في مركز الرعاية
You will be taken to a recovery area until the effects of your medicines have worn off. In most cases, you will be observed for about an hour. If you feel well, you can then go home.
في البيت
After returning home, you should do the following:
- Follow your doctor’s instructions regarding your diet.
- Avoid driving or using heavy machinery for at least a day after your procedure. Sedatives may slow your reaction time.
- Avoid drinking alcohol for at least a day after your procedure.
- الحصول على الكثير من الراحة.
In the days or weeks after your procedure, the tissue that was banded will slough off.
استدعاء الطبيب
بعد وصوله الى المنزل ، اتصل بطبيبك إذا كان أي من الحالات التالية:
- علامات الإصابة, بما في ذلك حمى وقشعريرة
- Bleeding from the mouth
- Increasing pain
- استفراغ و غثيان
- Bloody vomit
- صعوبة في البلع
- السعال، ضيق التنفس، أو ألم في الصدر
- Dizziness or weakness
- Bloody or dark black stools
- ألم شديد في البطن
في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.