Services

• Diagnostic Upper GI Endoscopy, Gastroscopy
• Diagnostic Lower GI Endoscopy, Colonoscopy
• Diagnostic Enteroscopy

Therapeutic Upper GI Endoscopy

• Esophageal Stricture Dilatation
• Esophageal Variceal Band Ligation
• Esophageal Polyp Removal
• Gastric Variceal Glue Injection
• APC for Gastric Telangiectasias
• Peptic Ulcer Disease Endoscopic Treatment
• Foreign Body Removal
• Percutaneous Endoscopic Gastrostomy
• Balloon Dilatation for Gastro Outlet Obstruction
• Esophageal Metal Stenting for Advanced Malignancy
• Gastric and Duodenal Stenting for Advanced Malignancy
• Endoscopic Bariatric Balloon Placement

Therapeutic Lower GI Endoscopy (Colonoscopy)

• Colonoscopic Polypectomy
• Colonic Balloon Dilatation
• Colonic Decompression for Colonic Psuedo Obstruction

Interventional ERCP

• Removal of Bile and Pancreatic Duct Stones
• Pancreatic and Bile Duct Stenting
• Intraductal Cholangio-Pancreatoscopy for Large Bile Duct and Pancreatic Duct Stones

Interventional EUS

• Diagnosis and staging of Malignancy, Tissue Diagnosis by FNAC / FNAB
• Pancreatic and Bile Duct Drainage
• Pancreatic Fluid Collection Drainage

Third Space Endoscopy

• POEM
• Endoscopic Mucosal Resection
• Endoscopic Submucosal Dissection

Esophageal Variceal Band Ligation

Esophageal Variceal Band Ligation (EVBL) is a life-saving endoscopic procedure used to treat esophageal varices—enlarged, swollen veins in the lower esophagus. These varices are commonly caused by portal hypertension due to chronic liver diseases such as cirrhosis. If untreated, varices can rupture and bleed, leading to a medical emergency.

What are Esophageal Varices?

Esophageal varices develop when blood flow through the liver is obstructed, often due to liver cirrhosis. This causes increased pressure in the portal vein, forcing blood into smaller veins in the esophagus. These veins become enlarged and fragile, with a high risk of rupture and massive bleeding.

Symptoms of Variceal Bleeding:

• Vomiting blood (hematemesis)
• Black or tarry stools (melena)
• Dizziness or fainting
• Low blood pressure
• Shock, in severe cases

Immediate treatment is essential to control bleeding and save life.

What is Band Ligation?

Band ligation is an endoscopic treatment to prevent or stop bleeding from esophageal varices. During the procedure:

• A flexible endoscope is inserted through the mouth.
• Rubber bands are placed around the base of the varices.
• The banded veins are cut off from blood supply and shrink over time, reducing the risk of rupture.

When is EVBL recommended?

• After a variceal bleed (emergency treatment)
• As a preventive measure in high-risk patients with cirrhosis
• In combination with medications like beta-blockers to reduce portal pressure

Benefits of EVBL:

• Quick and effective control of variceal bleeding
• Minimally invasive
• Can prevent future bleeding episodes
• Often performed on an outpatient or short-stay basis

Is the procedure safe?

Yes, when performed by experienced gastroenterologists, EVBL is highly effective and generally safe. Possible side effects may include:

• Mild chest discomfort
• Ulcer formation at the ligation site
• Rarely, esophageal stricture or re-bleeding

Post-procedure care:

• Observation for a few hours after the procedure
• Soft diet for a few days
• Acid-suppressing medications may be prescribed
• Follow-up repeat banding sessions may be required
• Ongoing liver disease management is essential

Esophageal variceal band ligation is a critical tool in managing complications of liver disease, helping to prevent or stop bleeding and protect patients from life-threatening consequences.