To investigate the efficacy of gastric variceal ligation (GVL) for gastric variceal hemorrhage(GVH).

Fifty-eight patients diagnosed by gastroscope as liver cirrhosis and portal hypertension with acute GVH from July 2008 to March 2012 in the Third Affiliated Hospital of Sun Yat-Sen University were enrolled in the prospective study. Local ethical committee approval had been received and that the informed consent of all participating subjects was obtained. The patients including 48 males and 10 females were randomized to GVL group (n=28) and gastric variceal obliteration with adhesive (GVO) group (n=30). The patients were followed up and the 24 h bleeding control, rebleeding rate, gastric variceal(GV) basic disappearance rate, remission rate, complications and death rate were observed and compared by χ² test.

The band ligation of GVL group was (3.5±1.4) circles. The injecting dose of tissue adhesive n-butyl-2-cyanoacrylate in the GVO group was 1-3(median 2)ml according to the diameter of varice mass. The injection points were 1- 4 (median 2). Fifteen and 11 cases with acute active bleeding were observed in the GVL and GVO group respectively. Bleeding control rates in 24 h of both groups were 100%. The total effective rate of two groups were 72%(20/28) and 70%(21/30) respectively. The GV basic disappearance rate were 29% (8/28) and 27% (8/30) and the remission rate were 43% (12/28) and 43% (13/30) . There was no differences between two groups in the GV basic disappearance rate and remission rate (χ²=0.026, 0.001, all in P>0.05) . There was no differences between two groups in the 1, 6, 12 months accumulated rebleeding rate (χ²<0.001, χ²=0.009, 0.043, all in P>0.05). No complications such as ectopic embolism and perforation were observed in two groups. The death rates of GVL and GVO group were 7% (2/28)and 10%(3/30). No differences were observed(χ²<0.001, P>0.05).

GVL is the safe and effective method in treatment of gastric variceal hemorrhage as GVO.