Efficacy and Safety of Endoscopic Treatment for Esophageal Varices in Children: A Single-center Retrospective Study

Endoscopic treatment is widely used for the management of esophageal varices in children; however, pediatric data on treatment outcomes and safety remain limited. The aim of this study was to evaluate the efficacy and safety of endoscopic variceal band ligation and sclerotherapy in children with esophageal varices, by assessing procedure-related complications and variceal eradication during follow-up endoscopic examinations. Patients who underwent endoscopic variceal band ligation or sclerotherapy between January 1, 2008, and June 1, 2026, at the Division of Pediatric Gastroenterology, Gazi University Faculty of Medicine, were retrospectively included in this study. Clinical and endoscopic data were retrospectively collected from patients’ medical records. A total of 55 patients (65.5% boys) with a mean age of 9.0±3.6 years were included. Overall, 65 variceal eradication attempts and 140 endoscopic procedures were evaluated. A total of 86 endoscopic variceal band ligation procedures and 5 sclerotherapy procedures were performed. Follow-up endoscopy was available for 48 eradication attempts. Complete eradication was achieved in 13 attempts (27.1%), partial response in 21 (43.8%), and no response in 14 (29.1%), resulting in an overall endoscopic response rate of 70.9%. Gastroesophageal varices regressed in 44.8% of cases. Early procedure-related bleeding occurred after one band ligation and one sclerotherapy procedure, corresponding to an overall bleeding complication rate of 2.2%. Endoscopic variceal band ligation appears to be a safe treatment option for esophageal varices in children, with a low rate of procedure-related complications and favorable endoscopic responses in most evaluable treatment courses. Prospective multicenter studies with standardized follow-up protocols are needed to further evaluate long-term outcomes in pediatric portal hypertension.