scholarly journals A meta-analysis of endoscopic variceal ligation for primary prophylaxis of esophageal variceal bleeding

Hepatology ◽  
2001 ◽  
Vol 33 (4) ◽  
pp. 802-807 ◽  
Author(s):  
T Imperiale
Keyword(s):  
Variceal Bleeding ◽  
Meta Analysis ◽  
Primary Prophylaxis ◽  
Endoscopic Variceal Ligation ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding

scholarly journals Short-course vasoconstrictors are adequate for esophageal variceal bleeding after endoscopic variceal ligation: A systematic review and meta-analysis

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110317
Author(s):  
Jen-Hao Yeh ◽  
Gin-Ho Lo ◽  
Ru-Yi Huang ◽  
Chih-Wen Lin ◽  
Wen-Lun Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Failure ◽  
Variceal Bleeding ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Endoscopic Variceal Ligation ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Short Course ◽  
Significant Difference

Endoscopic variceal ligation (EVL) with vasoconstrictors has been recommended for acute esophageal variceal bleeding. However, the optimal duration of vasoconstrictors after EVL is controversial. This systematic review and meta-analysis was conducted to explore the efficacy of short-course vasoconstrictors (≤3 days) versus standard combination (3–5 days). A comprehensive literature review was conducted using the PubMed, Embase, and Cochrane library databases with subsequent meta-analysis. The primary outcomes were 5-day rebleeding, mortality, and treatment failure rates. A risk ratio (RR) with 95% confidence interval is used for outcome comparison. Nine randomized studies with 838 patients were included. The initial hemostasis (96.8% vs 97.4%, p = 0.919), 5-day rebleeding (11.2% vs 8.3%, RR = 1.05, 95% CI = 0.62–1.76), mortality (0 vs 1.3%, RR = 0.48, 95% CI = 0.10–2.39), and treatment failure (7.4% vs 5.9%, RR = 1.10, 95% CI = 0.48–2.49) were similar in both groups. Subgroup analysis suggested EVL alone had no significant difference of 5-day re-bleeding (15.9% vs 7.1%, RR = 2.25, 95% CI = 0.87–5.77), mortality (0 vs 0.7%, RR = 0.71, 95% CI = 0.08–6.03), treatment failure (9.6% vs 6.7%, RR = 1.43, 95% CI = 0.54–3.75) compared to standard combination. Clinical heterogeneity was found for the rebleeding rate for the subgroup during sensitivity analysis. EVL with short-course vasoconstrictors is highly efficacious for esophageal variceal bleeding. Further studies are required to determine the genuine need of subsequent vasoconstrictor after successful EVL.

scholarly journals Necessity of vasoconstrictors for esophageal variceal bleeding after endoscopic ligation: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Jen-Hao Yeh ◽  
Gin Lo ◽  
Ru-Yi Huang ◽  
Chih-Wen Lin ◽  
Wen-Lun Wang
Keyword(s):  
Treatment Failure ◽  
Variceal Bleeding ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Current Evidence ◽  
Cochrane Library ◽  
Combination Regimen ◽  
Endoscopic Variceal Ligation ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding

Abstract BackgroundSeveral recent trials have suggested that the need for vasoconstrictors for preventing esophageal variceal bleeding may be considerably reduced after endoscopic variceal ligation (EVL). However, comprehensive systematic reviews on this topic are hardly available. MethodsA meticulous literature review and meta-analysis were conducted using the databases of PubMed, Embase, and the Cochrane Library. Primary outcomes were initial hemostasis, rebleeding, mortality, and treatment failure within 5 days, and secondary outcomes were 6-week mortality and adverse events. ResultsFive randomized trials with 423 participants were included in the meta-analysis. The results revealed that the following outcomes were similar in groups that received only EVL and a standard combination regimen: initial hemostasis (97.6% vs. 98.0%, risk ratio (RR) = 1.00, 95% confidence interval (CI) = 0.97–1.02), 5-day rebleeding (15.9% vs. 6.6%, RR = 2.25, 95% CI = 0.87–5.77), treatment failure (9.6% vs. 6.7%, RR = 1.43, 95% CI = 0.54––3.75), 5-day mortality rates (0 vs. 0.7%, RR = 0.81, 95% CI = 0.09–6.87), and 6-week mortality rates (2.9% vs. 3.0%, RR = 0.88, 95% CI = 0.25–3.13). By contrast, sensitivity analysis suggested obvious clinical heterogeneity in 5-day rebleeding although an outlier study was identified. ConclusionIn patients with acute esophageal variceal bleeding after EVL, 5-day and 6-week mortality rates were similar regardless of vasoconstrictor use. However, considering the controversial 5-day rebleeding rate, short course of vasoconstrictor use based on current evidence may be reasonable.

scholarly journals Meta-analysis: beta-blockers versus banding ligation for primary prophylaxis of esophageal variceal bleeding

2012 ◽  
Vol 11 (3) ◽  
pp. 369-383 ◽  
Author(s):  
Natalie Funakoshi ◽  
Yohan Duny ◽  
Jean-Christophe Valats ◽  
Frédérique Ségalas-Largey ◽  
Nicolas Flori ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Beta Blockers ◽  
Meta Analysis ◽  
Primary Prophylaxis ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Banding Ligation

scholarly journals Mo1531 – Early (Pre-Emptive) Tips Versus Conventional Treatment for Prophylaxis of Esophageal Variceal Bleeding: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 156 (6) ◽  
pp. S-1333-S-1334
Author(s):  
Shadi Hamdeh ◽  
Osama Altayar ◽  
Muhammad Aziz ◽  
Jihan Fathallah ◽  
Mojtaba S. Olyaee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Variceal Bleeding ◽  
Conventional Treatment ◽  
Meta Analysis ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding
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