Endoscopic treatment of gastric varices: Use of band ligation, cyanoacrylate glue and novel therapies

Gastric varices are found in a significant number of patients with portal hypertension. There are several endoscopic treatment options for gastric varices, but none have gained widespread use among endoscopists. Rubber band ligation of gastric varices has been used with success in several small case series of patients. Detachable snare ligation has also been used, but experience with this technique is limited. Thrombin injection offers a potential treatment option, but it too requires further investigation. Adhesive injection therapy shows much promise in providing successful variceal obliteration in a cost effective manner. Complications, as described with each of these endoscopic methods, require that great care be taken even in the hands of the most experienced endoscopist when treating gastric varices.