Low-pressure endoscopy using the gel immersion method facilitates endoscopic variceal ligation of ruptured esophageal varices

Although endoscopic variceal ligation (EVL) is a standard procedure in the management of acute variceal bleeding [1], it is often difficult to secure the visual field because the lumen is filled with fresh blood and the injected water rapidly mixes with blood. For previously treated varices, it may also be difficult to adequately aspirate fibrotic varices into the banding cap.