Endoscopic Band Ligation
(Esophageal Band Ligation)
by Krisha McCoy, MS
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.
Reasons for Procedure TOP
This procedure is done to prevent or treat bleeding from esophageal varices (enlarged veins). If left untreated, varices could rupture and bleed severely.
Possible Complications TOP
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Some factors that may increase the risk of complications include:
What to Expect TOP
Prior to Procedure
Description of the Procedure TOP
For this procedure, you will lie on your left side. If you are not intubated 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.
How Long Will It Take? TOP
Typically, less than one hour
Will It Hurt? TOP
You will usually feel some pressure and discomfort, but not pain, during the procedure. After the procedure, your throat may feel irritated and sore.
Post-procedure Care TOP
At the Care Center
You will be taken to a recovery area until the effects of your medications have worn off. In most cases, you will be observed for about an hour. If you feel well, you can then go home.
After returning home, you should do the following:
In the days or weeks after your procedure, the tissue that was banded will slough off.
Follow-up with you doctor as directed. You may need additional procedures.
Call Your Doctor TOP
Call your doctor if any of the following occurs:
If you think you have an emergency, call for medical help right away.
American Society for Gastrointestinal Endoscopy
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Association of Gastroenterology
Asge Technology Committee, Conway JD, et al. Endoscopic hemostatic devices. Gastrointest Endosc . 2009;69(6):987-996.
Poza Cordon J, Froilan Torres C, et al. Endoscopic management of esophageal varicies. World J Gastrointest Endosc. 2012;4(7):312-322.
Baron TH, Wong Kee Song LM. Endoscopic variceal band ligation. Am J Gastroenterol. 2009 May;104(5):1083-5.
Upper GI endoscopy. National Digestive Diseases Clearinghouse website. Available at:
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Updated April 23, 2012. Accessed July 15, 2013.
Last reviewed June 2014 by Michael Woods, MD
Last Updated: 7/18/2014