ABSTRACT

Endoscopic laser photocoagulation has been in clinical use in Europe since 1975. The remainders were using the Spectra-Physics Argon ion laser. The reported length of laser shot varied considerably, from ½ to 4 sec. Most centers did not have any fixed maximum duration for laser exposure. The majority were treated with Neodymium-Yag lasers in uncontrolled studies. The Neodymium-Yag laser appears to give excellent results in patients with bleeding esophageal varices. Endoscopic laser photocoagulation is already being used widely in European patients. The spread of laser photocoagulation, particularly with the Neodymium-Yag instrument in Germany, is largely due to the enthusiasm of Kiefhaber and his group in Munich. The high cost of laser equipment is a major disincentive to the uncommitted and has provided a major stimulus to the development and reevaluation of alternative endoscopic techniques. Techniques, definitions, indications for surgery, and particularly the selection of patients for endoscopic treatment, all differ between centers.