Endoscopic banding, commonly known as endoscopic variceal band ligation, is a minimally invasive endoscopic treatment used primarily to control or prevent bleeding from enlarged veins, known as oesophageal varices. These varices can develop in people with certain chronic liver conditions and portal hypertension.
When it is recommended
Endoscopic banding may be recommended when oesophageal varices are identified and are considered at risk of bleeding, or when active or recent variceal bleeding requires treatment. Gastroenterologists determine the need for banding based on the patient's liver condition, endoscopic findings, bleeding risk and overall clinical status.
About the procedure
During the procedure, an endoscope is passed through the mouth to examine the oesophagus. A specialised banding device attached to the endoscope allows the doctor to place small elastic bands around selected varices. The bands reduce blood flow through the enlarged vein, causing it to shrink and eventually detach.
When performed for active gastrointestinal bleeding, endoscopic banding may form part of urgent bleeding management alongside medical stabilisation and other appropriate treatments. Multiple varices may be treated during one session depending on their size, location and the patient's clinical condition.
Patients may require follow-up endoscopy sessions because varices can recur or additional enlarged veins may become apparent. Management may also include treatment of the underlying liver disease and portal hypertension. After the procedure, patients receive instructions regarding diet, medications, warning symptoms and follow-up care.
