Efficacy of endoscopic variceal ligation and sclerotheraphy in treatment of acute variceal bleeding

2007 ◽  
Vol 45 (05) ◽  
Author(s):  
C Rédei ◽  
M Szőnyi ◽  
A Zaja ◽  
L Tóth ◽  
Á Svejkovszky ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Endoscopic Variceal Ligation ◽  
Acute Variceal Bleeding

Who should receive endoscopic variceal ligation after recovering from acute variceal bleeding?

Hepatology ◽  
2018 ◽  
Vol 67 (5) ◽  
pp. 2057-2058 ◽  
Author(s):  
Xingshun Qi ◽  
Nahum Méndez-Sánchez ◽  
Andrea Mancuso ◽  
Fernando Gomes Romeiro ◽  
Xiaozhong Guo
Keyword(s):  
Variceal Bleeding ◽  
Endoscopic Variceal Ligation ◽  
Acute Variceal Bleeding

scholarly journals The Presence of Ascites Affects the Predictive Value of HVPG on Early Rebleeding in Patients with Cirrhosis

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Chuan Liu ◽  
Ruoyang Shao ◽  
Sining Wang ◽  
Guangchuan Wang ◽  
Lifen Wang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Variceal Bleeding ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Venous Pressure ◽  
Predictive Performance ◽  
Bleeding Risk ◽  
Endoscopic Variceal Ligation ◽  
Acute Variceal Bleeding ◽  
Cirrhotic Patients

Background and Aims. Gastroesophageal variceal bleeding is a serious complication of portal hypertension in cirrhotic patients and could be predicted by hepatic venous pressure gradient (HVPG). However, whether the presence of ascites affects the prognostic value of HVPG for patients with acute variceal bleeding is still unknown. This retrospective study is aimed at investigating the influence of ascites on predictive performance of HVPG for early rebleeding in cirrhotic patients with acute variceal bleeding. Methods. In this retrospective study, a total of 148 patients with cirrhosis hospitalized for acute variceal bleeding who underwent HVPG measurement and endoscopic variceal ligation (EVL) for the prevention of rebleeding were included. The receiver operating characteristic curve (ROC) and logistical regression method were employed to analyze the predictive performance of HVPG for early rebleeding. The locally weighted scatterplot smoothing approach was adopted to assess the monotonicity between bleeding risk and HVPG. Results. A significantly higher HVPG level was observed in patients with early rebleeding compared to patients without rebleeding in the nonascites cohort. When using HVPG to predict early rebleeding, there was a lower area under curve in the ascites cohort compared to the nonascites cohort. HVPG was recognized as a risk factor for early rebleeding by a logistic regression model only in the nonascites cohort. An overall monotonicity in the trend of change in HVPG and risk for early rebleeding was observed in the nonascites cohort solely. Conclusion. The predictive value of HVPG for early rebleeding in patients with cirrhosis that developed acute variceal bleeding is hindered by the presence of ascites.

scholarly journals Outcome of Endoscopic Variceal Band Ligation

2017 ◽  
Vol 56 (206) ◽  
Author(s):  
Barun Shrestha ◽  
Sudhamshu KC ◽  
Sita Ram Chaudhary ◽  
Bhupendra Kumar Basnet ◽  
Amrendra Kumar Mandal ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Esophageal Varices ◽  
Variceal Bleeding ◽  
Endoscopic Examination ◽  
Endoscopic Variceal Ligation ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Acute Variceal Bleeding ◽  
Red Color ◽  
Pugh Class

Introduction: Bleeding from esophageal varices in cirrhosis is an emergent condition with high mortality. One of the preferred modality of treating esophageal varices is EVL. We aimed to find out the outcome of EVL in controlling acute esophageal variceal bleeding, prophylactic banding to prevent future bleeding and the number of sessions required for complete eradication of varices.Methods: This descriptive observational study was carried out in Gastroenterology and Hepatology unit of Bir Hospital, NAMS from June 2016 to May 2017. Consecutive cases who presented in emergency room with acute variceal bleeding due to liver cirrhosis and cases of liver cirrhosis with large varices and red color signs on endoscopic examination were enrolled. They underwent EVL and subsequent re-endoscope at one month interval till the eradication of varices was achieved. Results: Among 83 patients, 15 (18.1%) were of Child Pugh class A, 29 (34.9%) B and 39 (47%) were of C. In 20 (24.1%) cases varices could be eradicated in one session of EVL while 57 (68.7%) required two sessions and in 6 (7.2%) cases it took three sessions. Total average EVL session required for obliteration of esophageal varices was 1.84±0.53. There was only one (1.2%) of early re-bleeding post EVL.Conclusions: EVL is an effective modality of treatment in controlling acute esophageal variceal bleeding, in preventing future variceal bleeding as well as in eradicating esophageal varices, with very few complications.Keywords: acute variceal bleeding; cirrhosis; endoscopic variceal ligation; large varices; red color sign. [PubMed]

EFFICACY OF CARVEDILOL COMBINED WITH ENDOSCOPIC VARICEAL LIGATION IN THE PREVENTION OF RECURRENT VARICEAL BLEEDING IN PATIENTS OF CIRRHOSIS

2016 ◽  
pp. 23-30
Author(s):  
Van Huy Tran ◽  
Thi Ngoc Diep Bui
Keyword(s):  
Side Effects ◽  
Beta Blocker ◽  
Variceal Bleeding ◽  
Poor Prognosis ◽  
Oesophageal Varices ◽  
Endoscopic Variceal Ligation ◽  
Efficacy And Safety ◽  
Orthostatic Hypertension ◽  
Key Words Carvedilol ◽  
Very High

Background: The recurrent variceal bleeding is still very high with a very poor prognosis. The combination of a non-selective beta-blocker and endoscopic variceal ligation (EVL) is still a standard therapy for the prevention, but many patients showed no response to propranolol. Carvedilol is a new, non-selective beta-blocker having intrinsic alpha-blocker activity, but the data about the efficacy and safety of carvedilol is still very limited. This study is aimed at assessing the efficacy and safety of carvedilol combined with EVL in the prevention of recurrent variceal bleeding. Patients and methods: 33 patients having variceal bleeding were enrolled. All patients received carvedilol and were performed the EVL until variceal eradication. All the patients were followed after 9 months. Results: rate of variceal eradication of oesophageal varices was 87.88%; the recurrence rate of variceal bleeding was 12.12% after 9 months. The side effects of carvedilol were rare and not severe, including vertiges, headache, and orthostatic hypertension. Conclusion: Carvedilol combined with EVL appeared as a relatively safe and effective in the prevention of recurrent variceal bleeding in patients of cirrhosis. Key words: carvedilol, variceal bleeding, EVL

PROGNOSTIC VALUE OF COMBINATION AIMS65 AND MELD SCORES IN CIRRHOTIC PATIENTS WITH ACUTE VARICEAL BLEEDING

2019 ◽  
pp. 35-40
Author(s):  
Thi Nhung Nguyen ◽  
Trung Nam Phan ◽  
Van Huy Tran
Keyword(s):  
Clinical Practice ◽  
Portal Hypertension ◽  
Key Words ◽  
Variceal Bleeding ◽  
Prognostic Value ◽  
High Rate ◽  
Central Hospital ◽  
Acute Variceal Bleeding ◽  
Cirrhotic Patients ◽  
Sensitivity Specificity

Bacground: Variceal bleeding is a severe complication of portal hypertension due to cirrhosis with high rate of motality, hence, predicting early rebleeding and mortality in cirrhotic patients with acute variceal bleeding is vital in clinical practice. Objectives: To evaluate the prognostic value of the combination of AIMS65 and MELD scores in predicting first 5 days in-hospital rebleeding and mortality in cirrhotic patients with acute variceal bleeding. Materials and Methods: 44 cirrhotic patients with acute variceal bleeding hospitalized at Hue Central Hospital. MELD and AIMS65 scores were calculated within the first 24 hours and monitoring rebleeding and mortality in the first 5 days in these patients. Results: AIMS65, MELD scores can predict first 5 days rebleeding and mortality with AUROC are 0.81, 0.69 and 0.92, 0.95, respectively. Combination of AIMS65 and MELD scores can predict first 5 days in hospital rebleeding with AUROC is 0.84, sensitivity 83.3%, specificity 81.6% (p<0.001) and mortality with AUROC is 0.96, sensitivity 100%, specificity 92.7% (p<0.001). Conclusions: The combination of AIMS65 and MELD scores increased the sensitivity, specificity and prognostic value in predicting first 5 days in-hospital rebleeding and mortality in cirrhotic patients with acute variceal bleeding in compare to each single scores. Key words: AiMS65 score, MELd, acute variceal bleeding

Sign in / Sign up

Export Citation Format

Share Document