Combined endoscopic clipping and injection sclerotherapy for esophageal varices

Endoscopic variceal ligation using elastic bands has been widely employed since the introduction of the technique.1 In Japan, another method whereby esophageal varices are ligated by an endoscopically guided clipping device (HX-3L, Olympus Optical Co., Ltd., Tokyo, Japan) was meanwhile devised.2,3 We undertook a trial of the clipping device electively in patients with severe liver dysfunction in whom we doubted that endoscopic injection sclerotherapy (EIS) alone would suffice. The result was that complete eradication of esophageal varices was seldom achieved.